Participant Form​

Completing this form is compulsory for all participants attending the Bali retreat(s).

    Personal Details

    Max file size: 20MB
    Max file size: 20MB

    Emergency Contact Details

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    Terms and Conditions

    I understand and agree:
    1. that my deposit is non-refundable and I have read and understand the Cancellation and Refund Policy.
    2. I must complete and return this form prior to the retreat or on arrival and I understand it is a requirement of participation in the retreat to provide correct information and to have comprehensive travel insurance with relevant inclusions.
    3. that I am participating in a moderately active retreat and may find it physically challenging at times. There will be one or more yoga/meditation classes daily along with hiking excursion. The onus is on me, the participant, to ensure that I am physically fit to undertake the activities.
    4. I take full responsibility for my own health and well-being during the retreat. I understand  Kookaburra Yoga and the retreat facilitators are not responsible or liable for any injuries or other medical or emotional problems if they occur. I understand that participation in programmed retreat activities is at my own discretion and is not compulsory.
    5. Kookaburra Yoga reserves the right to cancel the retreat up to 3 weeks prior to commencement date. If this is to occur, Kookaburra Yoga will notify me in advance and give me a full refund within 30 days of cancellation.
    6. Kookaburra Yoga may cancel or postpone the retreat 0-3 weeks prior to the commencement date if there is a high risk of natural disasters or Acts of God making travel untenable or the retreat unsafe.
    7. I understand that Kookaburra Yoga isn’t responsible for any additional expenses incurred in relation to this retreat which are not specifically referenced in the itinerary, nor any medical and preparation expenses.
    8. Kookaburra Yoga shares information in this form and information collected from participants with third party tour organiser Essential Retreat Organiser.
    9. Kookaburra Yoga will not share any information contained in this form with any other 3rd party without my permission, unless there is a medical emergency and the retreat organisers deem it necessary.

    Cancellation & Refund Policy

    • Travel insurance on this retreat is compulsory. Please provide your certificate of insurance with this form.
    • A deposit of $500 is required upon booking a place on these Retreats and confirms your place and room option selected. Your deposit is your commitment to attend and is non-refundable unless we can offer your place to a waitlisted person or you find someone to take your place.
    • If you cancel 0-2 weeks before the retreat the full amount is payable.
    • If you cancel 2-4 weeks before the retreat 75% of your payment (minus deposit) will be refunded to you.
    • If you cancel more than 4 weeks prior to the retreat your full payment (minus deposit) will be refunded to you.
    • If you need to cancel due to ill health or the death of someone close to you, your travel insurance policy may refund your deposit and all other money paid back to you. Please check with your insurer. 
    • If the retreat is cancelled or disrupted due to Acts of God or natural disasters please contact your travel insurer for a refund or reimbursement.

    Release of Liability Agreement

    I understand and accept that Kookaburra Yoga and the retreat facilitators are NOT liable for any injury or damages to person or property –  travelling to and  from this retreat, and while participating in this retreat.
    I understand that it is a condition of participation in this retreat to organise my own comprehensive insurance and provide the retreat organisers with the certificate of currency prior to the retreat commencement date.
    Kookaburra Yoga provides a safe environment for yoga facilitated by experienced teachers, and I agree my participation in yoga and meditation is at my own discretion and accept full responsibility for any loss or injury incurred. I agree to participate in the excursions organised on this retreat at my own discretion and accept full responsibility for any loss or injury incurred.
    I have read the Terms and Conditions and understand and accept them. I understand that it is compulsory to accurately complete and return this form prior to the retreat.
    By submitting this form I am agreeing to:
    • Terms and Conditions 
    • Cancellation and Refund Policy
    • Release of Liability of Kookaburra Yoga