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Rajayogini Liability Waiver must be filled out prior to the Retreat 

Please read in it's entirety and sign at the bottom

Retreat Waiver

Are you currently suffering from a medical condition, illness, or injury?



Dear participant,

Rajayogini LLC  is proud to create these retreats for your enjoyment. We ask that you read and sign this waiver of liability. By signing it, you will be indicating that you understand the risks and take responsibility for your physical and emotional well-being. We hope that if anything should come up for you during your stay that you are able to reach out for help if you need something. We have found from past retreats that most accidents and other challenges can be avoided if you stay grounded in your body and seek assistance before something becomes a problem.


I acknowledge that I have voluntarily applied to participate in the Yoga & Mediation Retreat to Bali referred to below as “this event”. In consideration the retreat leader accepting my application for participation in this event, I agree to this release of claims, waiver of liability and assumption of risks.

On behalf of myself, my heirs, executors, successors, administrators and any other person who may have an interest at common law or by operation of statue, I hereby waive any and all claims I or such parties may have now or in the future. I release from liability Rajayogini LLC, and any employees, guides, agents or representatives (“the releases”) for any personal injury, death, property damage or loss or any nature suffered by me as a result of participation in any activity on the retreat.

I release from liability the retreat leaders, Rajayogini LLC, and their assistants. For any cause whatsoever including those arising out of, or in any way connected to or occasioned by the negligence of the releases.

  1. The terrain, natural areas and the mountains and ocean are subject to natural forces which result in obstacles and hazards.

  2. Weather: Weather may change rapidly and may be extreme, presenting significant challenges.

  3. I acknowledge the enjoyment and challenge I receive from the activities of this retreat and emotional experiences resulting from personal  growth exploration, this is my reason for participating in this event, and I voluntarily assume all risks associated with these activities and freely waive any and all legal rights that I may have against the releases.


As consideration for being permitted by the retreat leaders, Rajayogini LLC to participate in these activities, I hereby agree that I, my assignees, heirs, distributes, guardians, and legal representatives will not make a claim against, sue or attach the property of the retreat leaders, Rajayogini LLC, their affiliates, employees, agents or volunteers or any of their affiliated organizations for injury or damage resulting from acts, howsoever caused, by any employee, agent or contractor, or any of their affiliated organizations, as a result of my participation in this event. I hereby release the retreat leaders, Rajayogini LLC and any of their agents or affiliated organizations form all actions, claims or demands that I, my assigns, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury, damage, or death resulting from my participation in this event.

I am medically, physically, emotionally and in all respects fit and able to participate in this event. I agree I will be fully and financially responsible for my own physical condition and well-being during the retreat and will follow the safety precautions and instructions prescribed by the retreat leaders, Rajayogini LLC

I acknowledge that Rajayogini LLC may make suggestions from time to time that are intended to help me and my well-being. However, I take ultimate responsibility for my choices and realize that they are not licensed medical providers and that I must consult my doctor. If I experience pain or discomfort during the retreat, I will notify the retreat leader, Rajayogini LLC. I will not hold Rajayogini LLC responsible for any pain or discomfort I experience during or after the retreat. I understand that the activities offered on this retreat are not a substitute for medical care. I understand that Rajayogini LLC is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat physical or mental illness.

I have read carefully and understand this agreement and/or its affiliated organizations, and sign it of my own free will.

Other Acknowledgements

You expressly acknowledge and understand that you will be automatically opted into communications from Rajayogini LLC with regard to the services provided, branding, marketing, or anything else and that it is your duty to opt out through the procedures outlined in such communications. You further expressly acknowledge and understand that your photo and/or video likeness may be used, without limitation, in connection with publicity, copyright, marketing, web content, social media, live stream, recorded classes, or other uses and that permission is expressly granted for such uses, and that no additional consideration outside of the services provided by Rajayogini LLC will be provided.

Thanks for submitting!

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