Retreat Registration Intake
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Retreat Liability Waiver and Participant Agreement
1. Personal Responsibility
I understand that participation in this retreat, including all breathwork sessions, embodiment practices, and optional medicine ceremonies, is entirely voluntary.
I take full responsibility for my physical, emotional, and mental well-being throughout the retreat and afterward.
2. Health Disclosure
I confirm that I have honestly disclosed all relevant physical and mental health information in the intake form.
I understand that certain medical conditions, medications, or psychological diagnoses may make participation unsafe.
It is my responsibility to consult with a qualified healthcare professional before attending.
3. Nature of the Work and Facilitator Role
I understand that breathwork, meditation, and medicine ceremonies can involve deep emotional and physical experiences.
These practices may bring up strong feelings, memories, or insights.
I acknowledge that the facilitators are not mental health therapists, counselors, medical professionals, or licensed practitioners.
Their guidance comes from personal experience, study, and practice, not from a clinical or diagnostic background.
They do not offer treatment, diagnosis, or therapy of any kind, and their role is to hold space, share tools, and support personal insight through experiential work. I am fully responsible to filter and see that these suggestions tools, and ideas work for me. And will communicate any question or needs.
By signing this agreement, I accept full legal and personal responsibility for my participation and for any decisions I make regarding my physical, emotional, or psychological well-being before, during, and after the retreat.
4. Assumption of Risk
I acknowledge that participation involves inherent risks, including but not limited to emotional release, physical exertion, dizziness, or changes in perception.
I freely choose to assume all such risks and waive any claim of liability against the facilitators, organizers, property owners, or associated staff for any injury, loss, or damages that may occur.
5. Substance, Ceremony, and Participation Agreement
If participating in any plant medicine or ceremony, I confirm that I am doing so by my own free will and have no known medical or psychiatric condition that would make participation unsafe.
I agree to follow all guidance, safety instructions, and schedules provided by the facilitators throughout the retreat.
Full participation in all scheduled programs and sessions is expected unless otherwise discussed and agreed upon in advance with the facilitators.
I agree not to leave the retreat property or separate from the group without prior communication and approval from the facilitators.
I agree not to bring, consume, or use any substances, alcohol, recreational drugs, or plant medicines during the retreat unless explicitly agreed upon with the facilitators.
I understand that these agreements are in place to create both my safety and the integrity of the collective process.
I also agree to follow all preparation and post-integration guidelines provided by the facilitators.
6. Confidentiality
I understand that what is shared by others during the retreat is confidential.
I agree to respect the privacy of all participants.
7. Media and Privacy
I understand that photography or video may be used respectfully during parts of the retreat.
I can choose to opt out at any time, and my privacy will be honored.
8. Payment and Refund Policy
I understand that my retreat spot is confirmed only after payment.
Deposits and payments are non-refundable unless stated otherwise by the organizers.
9. Legal Release
By signing this agreement, I release and hold harmless the facilitators (including Motty Kenigsberg and Joel Katz), the venue, and all supporting staff from any and all claims, damages, or liability arising from my participation in the retreat.
This release applies to any personal injury, property damage, or emotional distress that may occur before, during, or after the retreat.
10. Acknowledgment
I have read and understood this agreement.
I am participating voluntarily and understand that I may decline or withdraw from any activity at any time.