Dr.OM Yoga

Name

Email address

Address , City, State , Zip

Phone

Birth Date month/day/year

Select your TRIPLE accomodations

$450

Select your DOUBLE accommodations

$475

Select your SINGLE accommodations

$540

Emergency Contact Name & Contact number

Travel Companion (if applicable) for room assignment

Travel Companion Booking Information

I will be reserving and paying for my travel companion
My travel companion will be reserving and paying separately

Release and Waiver of Liability

RELEASE AND WAIVER OF LIABILITY DECLARATION OF HEALTH. By accepting this Yoga retreat Participant Agreement I represent that I have no physical conditions or medical precautions which would adversely affect my ability to take part in the yoga program or other physical or cultural activities offered on the yoga retreat. I fully understand that my participation in the yoga program or other activities could be injurious to my health and I voluntarily assume all risks related to such activities. PERSONAL RELEASE. By agreeing to the terms outlined here I hereby release and discharge my rights and claims for damages or liabilities that may occur as a result of participation on the yoga retreat, including but not limited to damages as a result of unexpected occurrences including those from weather, local political situations, wildlife or uncontrollable acts of God, including the risk of death. I release Buddhaful OM Yoga and Dr.OM LLC including its owners, directors, employees, guides, yoga teachers and partners from liability for personal injury, illness, emotional damage, incurred travel expenses or property damage I may incur as a result of participation on this trip. Activities may include but are not limited to: hiking, yoga, Environmental risks and hazards include wildlife; lightning, flash floods and unpredictable forces of nature. Possible injuries and illnesses include sunburn, heat stroke, dehydration and other mild or serious conditions. I acknowledge and understand that the Cassadaga Mystic Retreat may include risks of injury or death to participants. I understand the description above of these risks is not complete and that other unknown or unanticipated risks may result in property loss, injury or death. I agree to assume responsibility for the inherent risks identified herein and those inherent risks not specifically identified. I acknowledge that participation in this activity is purely voluntary, no one is forcing participation and participation is elected with full knowledge of the inherent risks. Medical Care Although I acknowledge that there is no obligation of any person to provide any participant with medical care during, prior to or after a Retreat, in the event medical treatment is provided to me I hereby consent to such care. Personal Property I acknowledge and agree that I am responsible for my equipment and all personal property during the Retreat and that the Released are not responsible in any way for such property whether it is lost, stolen or damaged. Words and Images I understand that during a Retreat I may be photographed, videotaped and or my words may be recorded and I authorize and allow Dr.OM LLC and its partners to use such images, words and likenesses for marketing, on websites, in brochures or other writings and any other legitimate purpose.

I accept the Release and Waiver of Liability

Terms of Service

TERMS OF SERVICE: DEPOSIT | PAYMENT | CANCELLATION POLICY | ACCOMMODATIONS Dr.OM LLC ( “Retreat Organizer”) include meals listed (2 breakfast, 1 lunch) , yoga classes, accommodations, all cultural and adventure excursions listed in the itinerary. Trips sometimes include tips and other services not listed in the itinerary. Trips never include alcoholic drinks, travel insurance, documentation, travel preparation, airport transfers or airfare. FULL PAYMENT (WITHIN 45 DAYS OF RETREAT) When you book you must pay in full. Upon receipt of your payment, we will send you a confirmation of your payment. Full payment is due 45 days prior to the start date of the yoga retreat. CANCELLATION POLICY Please note that there will be no refunds or discounts for arriving late, leaving early, flight cancellations, travel delays or illness. If you cancel your participation in a retreat for any reason, the cancellation policy below will apply, with no exceptions. We wish we could compensate people for unforeseen circumstances (injury, family emergency, etc.), but we have costs already incurred when reserving retreat accommodations. We have designed our cancellation policy to be as compassionate as possible in the case that your plans change. But to protect yourself further, we strongly encourage you to purchase travel insurance. IF YOU CANCEL THE YOGA RETREAT: 45 days or more prior to the start of the yoga retreat, you receive: 100% credit of the cost of the full retreat toward another Yoga Retreat within 12 months. 30-45 days prior to the start of the yoga retreat, you receive: 50% credit of the cost of the full retreat toward another Yoga Retreat within 12 months, and will forfeit the remainder. 0-30 days prior to the start of the yoga retreat, you receive: no refunds or credits will be given. To cancel, you must send an email stating that you wish to cancel to: dromyoga@gmail.com IF WE CANCEL THE YOGA RETREAT: If we cancel a trip due too few participants, we will refund to you all deposits and payments you have paid. We cannot however compensate you for airfare or travel costs incurred. In the unlikely event that we must cancel a yoga retreat due to weather, natural disaster or political upheaval, we cannot guarantee a refund – it will be depending on receiving a refund from the venue / tour operator we work with. To cover these risks, we highly recommend you purchase travel insurance. ACCOMODATIONS There are three types of accommodations for this specific retreat : Triple: Shared room 3 people $395 Double: Shared room 2 people $445 Single: Private room $535 *Itinerary subject to change without notice.

I accept the Terms of Service