Empower Training & Retreats Waiver (Retreat/Camp)
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Email *
First Name *
Last Name
Date of Birth *
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By entering into this agreement, I  understand that participating in an event hosted by Empower Yoga Retreats, LLC is physical in nature and there are inherent risks in participating in any of these events.  It is further understood that Empower Yoga Retreats, LLC is not responsible for the actions, behaviors or safety precautions of any vendor or site where a retreat is held. 
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Required
I represent that I (i) have no psychiatric, medical or physical condition or history which would prevent me from participating in or from utilizing any Empower Yoga Retreats, LLC or their partner/vendors facilities, equipment and/or services or that doing so with my condition could knowingly endanger myself or others, and (ii) has not been instructed by any physician not participate in or  to use any of Empower Yoga Retreats, LLC’s or their partner/vendor hosted activities, facilities, equipment and/or services or participate in any activities that are part of any proposed itinerary. 
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I recognize and acknowledges that there is a known risk of injury in participating in activities, utilizing the facilities and equipment at retreats hosted by Empower Yoga Retreats, LLC, including but not limited to participating in individual or group fitness programs. I do so at my own risk and knowingly and voluntarily assumes full responsibility for any injury or harm that may occur to me on any retreat hosted by Empower Yoga Retreats, LLC. I hereby holds harmless and fully and forever releases and discharges Empower Yoga Retreats, LLC and all associated businesses, its trustees, employees and agents from any and all claims, liabilities, debts, losses, expenses, attorneys' fees, demands, rights of action, or causes of action, present or future, whether known, anticipated or unanticipated, resulting from, arising out of or incident to my participation in any activity, use or intended or participation in or at any of Empower Yoga Retreats, LLC events, facilities, equipment or services. I shall participate in Empower Yoga Retreats, LLC’s  retreats, events, programs, facilities, equipment and services in a responsible manner and in compliance with all applicable rules and practices, and will report immediately any injuries and accidents that may occur to me, at any event hosted by Empower Yoga Retreats, LLC to my site host or retreat leader. Empower Yoga Retreats, LLC is not responsible for the loss of personal property. 
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I have read and agree to the terms & conditions of the retreat Terms & Conditions
I agree and understand that by signing the Electronic Waiver, that all electronic signatures are the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement.
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I have read, understand and agree to all the statements above. ** Please Sign your Full Name *
Todays Date *
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A copy of your responses will be emailed to the address you provided.
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