Retreat Waiver and Release
Name of Retreat:
Well Of Being: A Soul-O Retreat
Possible Retreat Activities:
Soulful Solo Spiritual alignment, contemplative silence, emotional release, movement, walking and meditation in the garden and inside. Personal healing experience and/or expression. Not limited to these activities. All activity is self-guided.
Retreat Organizer Name:
Melissa Laborsky MD of Indy Healing Center LLC (the “ Organizer” or “Retreat Host”)
Location:
Indy Healing Center LLC
7771 Spring Mill Road, Indianapolis, IN 46260
Acknowledgment and Assumption of Risk, Release, and Indemnification
I, __________________________ (enter name), hereby agree that by signing this document, I consent to waive certain legal rights, including the right to sue the organizer named above, and if applicable, its employees, owners, officers, directors, representatives, agents, volunteers and facilitators from any physical, material, tangible or intangible, loss or damages that may happen to me during my participating in the Retreat.
In consideration of the services and equipment provided by Melissa Laborsky MD (collectively referred to as the Retreat Host) at a retreat space in the United States (collectively, the Retreats), I hereby agree in this Acknowledgment and Assumption of Risk, Release, and Indemnification (Agreement) to release, indemnify and discharge Melissa Laborsky, on behalf of myself, my heirs, assigns, personal representative and estate and for all members of my family, including minor children, as follows:
1. I acknowledge that all Retreats entail known and unanticipated risks that could result in physical or emotional trauma, injury, paralysis, death or damage to myself, property and/or any third party. Although the Retreat host has taken reasonable steps to provide me with appropriate equipment and skilled instruction, I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of a Retreat.
2. I acknowledge and agree that I am over 18 years of age, in good health, and am physically and mentally capable of handling any proposed Retreat activity. If I do not feel physically or mentally prepared to participate in a Retreat activity, I will notify the host, and will voluntarily not participate in such activity or the Retreat itself. I fully understand that no refund (in whole or part) will be made for any non-participation in a Retreat. While the Retreat Host will endeavor to adhere to the proposed schedule and services of a Retreat, I agree that the Retreat Host has the final word and authority to make any changes to the same.
3. I am responsible for my own actions at any Retreat. I agree and understand that the Retreat Host assumes no responsibility for me and that my participation in all Retreats is purely voluntary and at my sole discretion. I am also aware of the potential stress, physical, and mental requirements of a Retreat, and I fully assume all responsibility of my own wellbeing and actions, both physically and mentally.
4. I am responsible if I do something disruptive, destructive, or illegal at a Retreat. Should I be found to possess any illegal drug or contraband at an Retreat, disrupt an Retreat activity to the point where such activity cannot be properly conducted, violate any applicable law or regulation at an Retreat location, or act without regard for the safety of another Retreat participant, present party, or property of the same at an Retreat, the Retreat Host in her sole discretion may ask me to leave such Event/Retreat. Under any such circumstances, I agree to forfeit any Retreat registration payments I have made. I will be totally responsible for any financial or physical damages incurred due to my actions or omissions at an Retreat, whether intentional or not.
5.I hereby voluntarily release, forever discharge and agree to indemnify and hold harmless the and the owners of the premises upon which the Retreat is conducted from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including without limitation attorney’s fees and costs which are in any way connected with my participation in an Retreat or my use of the Retreat Host’s equipment or facilities including any such claims which allege negligent acts or omissions of the Retreat Hosts.
6. I will not misappropriate or infringe the Retreat Host’s Materials. I understand and agree that all documents, ideas, scenarios, workbooks, movements, routines, choreography, and all other materials presented at an Retreat (collectively, Materials) are the confidential and proprietary property of the Retreat Host’s, and that I have only a limited right to use such Materials for my own personal use and purpose. Under no circumstances will I disclose these Materials to any other party or utilize them in any other manner, either for business or research purposes, without the prior written consent of the. I understand and agree that any such use would be an infringement on the ’s intellectual property rights, for which there are civil and criminal penalties.
7. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating in a Retreat, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have.
8. I expressly agree that this Agreement is intended to be as broad and inclusive as is permitted by Indiana state law and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
By signing this Agreement, I acknowledge that if anyone is hurt or property damaged during my participation in a Retreat, I may be found by a court of law to have waived my right to maintain a lawsuit against the Retreat Host on the basis of any claim from which have released them herein. I have had sufficient opportunity read this entire Agreement. I have read and understand it, and I agree to be bound by the terms of Agreement. By signing or listing your name below you are agreeing to be bound by the terms of Agreement.