COVID – 19 RELEASE OF LIABILITY AND WAIVER FORM 2023
Event Timing: June 29th-2nd 2023
Event Address: Lakulish Yoga and Health Retreat
8136 NC Highway 119 South
Mebane, NC 27302
Contact us at 1-336-421-0690 or lifemissionashram@gmail.com
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Lakulish Yoga and Health Retreat
COVID – 19 RELEASE OF LIABILITY AND WAIVER FORM
The novel coronavirus Covid-19 has been declared a worldwide pandemic by the World Health
Organization. Covid-19 is reported to be extremely contagious. The state of medical knowledge
continues to evolve, but the virus is believed to spread from person to person contact and by contact
with contaminated surfaces or objects, or through airborne exposure. People reportedly can be infected
and show no symptoms of the disease. Evidence has shown that Covid-19 can cause serious and even
life-threatening illness or death.

While measures to limit the spread of Covid-19 will be employed, Lakulish Yoga and Health Retreat
Youth Camp cannot prevent you or your child(ren) from being exposed or contracting Covid-19 while
attending the camp or being on the premises. Therefore, if you choose to utilize Lakulish Yoga and
Health Retreat’s services or enter the premises, you may be exposing yourself and child(ren) to and/or
increasing your risk of contracting or spreading Covid-19.

ASSUMPTION OF RISK:
I hereby choose to accept the risk for myself and child(ren) of being exposed to, contracting, and/or
spreading Covid-19 in order to enter the premises and attend the camp at Lakulish Yoga and Health
Retreat.

WAIVER OF LIABILITY
I hereby forever release and waive my right to bring suit against Lakulish Yoga and Health Retreat and its
agents, employees, volunteers, board members, and other representatives in connection with exposure,
infection, and/or spread of Covid-19 related to using the services or entering the premises of Lakulish
Yoga and Health Retreat. I understand that this waiver means that I give up my right to bring any claims
including for personal injuries, death, disease, property losses, or any other loss, including but not
limited to claims of negligence and give up any claim I my have to seek damages whether known or
unknown, foreseen or unforeseen.

CHOICE OF LAW:
I understand and agree that the law of the State of North Carolina will apply in this contract.
I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL THE PROVISIONS OF THIS RELEASE, AND FREELYAND KNOWINGLY ASSUME THE RISK AND WAIVE MY (AND MY CHILD(REN’S) RIGHTS CONCERNINGLIABILITY AS DESCRIBED ABOVE.
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