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The Exhale Retreat

Full Name

Date of Birth

Phone Number

Email

Emergency Contact (Name & Number)

To support you in the best possible way, we invite you to share: Is there anything about your physical or emotional wellbeing you feel we should be aware of:

Are you taking any medication?

Do you have injuries or physical limitations?

Do you have any allergies. (Any specific foods to avoid?)

Nourishment & Preferences

Nourishment & Preferences
A
B
C

Accommodation. Pick your preference

Accommodation. Pick your preference
A
B
C
Accommodation availability is on a first-come, first-serve basis. Book your spot at the earliest to ensure receiving your preferred option.

Do you have a preferred roommate?

What do you hope to achieve from this retreat?

Participation & Cancellation Policy

Participation in the retreat is confirmed upon payment. – A full refund will be issued for cancellations made at least 7 days prior to the retreat – Cancellations made less than 7 days before the retreat are non-refundable
By signing below, you acknowledge and accept these terms.

Voluntary Participation

By joining The Exhale Retreat, you acknowledge that your participation in any or all activities, including but not limited to yoga, breathwork, meditation, restorative movement, group sharing, and any other offered practice, is entirely voluntary. You are free to participate at your own pace and discretion.

Personal Responsibility

You agree to take full responsibility for your physical, emotional, and mental wellbeing during the retreat. You understand the importance of listening to your body, honoring your limits, and communicating any discomfort or concern to the facilitators.

Health Acknowledgement

By participating, you confirm that you are in a suitable physical and mental condition to engage in retreat activities, and you have disclosed any relevant medical conditions, injuries, or allergies in this registration form.
This retreat is now a substitute for medical, psychological, or therapeutic treatment.
If you are under medical care, you acknowledge that you have consulted with your healthcare provider prior to participation.

Assumption of Risk

You understand that participation in retreat activities may involve certain inherent risks, including but not limited to physical movement, emotional release or unforeseen reactions. By joining, you voluntarily assume all such risks.

Release of Liability

To the fullest extent permitted by law, you release and hold harmless:
Elias Farroukh (Elijah) and Sara Nasr, as facilitators of the Exhale Retreat, as well all retreat volunteers, from any and all liability, claims, demands, or causes of action arising out of or related to your participation.

Emotional & Energetic Work

You acknowledge that your emotional or introspective experience is personal and no specific results are guaranteed.

Personal Belongings

You are fully responsible for your personal belongings during the retreat. The facilitators and volunteers are not liable for any loss, theft, or damage.

Code of Respect

– Respect each other’s space, the facilitators, volunteers, and fellow participants

– Honor silence and rest when needed – Be mindful when using shared spaces – Keep the environment clean and considerate for others

– Maintain confidentiality within group sharing

Agreement

By signing below, you confirm that:
– You have read and understood this agreement – You agree to all terms stated above – You participate fully at your own responsibility

Please include your Signature below

Signature

Date