Participant Form​

Completing this form is compulsory for all participants attending a Kookaburra Yoga retreat. If you have booked on behalf of a friend please forward to them to complete prior the retreat commencement date.

    Personal Information

    GP Details

    Emergency Contact Details

    Terms and Conditions

    Please read and agree to the Terms and Conditions of attending this retreat by submitting this form.

    KOOKABURRA YOGA is a yoga and retreat organisation where participants join yoga retreats (“retreats”) at Kookaburra Yoga’s premises at 210 Carradine Road, Bedfordale and at other locations. Kookaburra Yoga’s retreats often include outdoor, hiking, sightseeing and other activities (“activities”) as specified in the retreat itineraries listed on www.kookaburrayoga.com which participants may join as part of the retreat. 

    Kookaburra Yoga is not an outdoor, hiking or travel organisation. When overseas, Kookaburra Yoga engages specialist travel agents and utilises the services of local providers to conduct the listed retreat activities. Managing travel agents are always listed on the webpage specific to the retreat.

    During local retreats at their own premises and in Western Australia, Kookaburra Yoga retreats may include hiking and bush walking activities offsite as listed on the website. For these activities, Kookaburra Yoga follows suggested guidelines for the hiking and outdoor components of retreats in accordance with the Western Australian Adventure Activity Standard Guidelines for Bushwalking published by the Department of Sport and Recreation .Cick to download and read it here

    PERSONAL RESPONSIBILITY
    By joining KOOKABURRA YOGA on a RETREAT, you acknowledge that you are participating in outdoor and sightseeing activities listed in the Retreat Itinerary which may be potentially dangerous including but not limited to; bushwalking, hiking, outdoor yoga with the facilitators, staff, sub-contractors and volunteers of KOOKABURRA YOGA. 

    There are risks involved in participating in these activities which could lead to serious injury, illness or death. These risks include but are not limited to:
    • rough terrain and obstacles
    • slippery and/or uneven surfaces
    • falling at edges of cliffs or elsewhere
    • over-exertion and cardiovascular stress
    • heat, cold and adverse weather conditions
    • plant and animal life
    • bushfire
    • There is also the risk that due to the location of some of the activities, medical, evacuation or search services might be slow.

    By booking ta Kookaburra Yoga Retreat and participating in the yoga and outdoor activities with Kookaburra Yoga, you agree that:
    • any activity in which you participate is within your capabilities
    • you are carrying the recommended equipment for the activity
    • you will declare any physical or other limitation that might affect your participation in the activity in writing prior to commencement of the activity
    • you will at all times remain with at least one person from the group during the activity
    • you will refrain from taking any illicit drugs or consuming alcohol during the retreat
    • you will accept the instructions of the leader of the activity
    • you have considered the risks before choosing to book and still wish to participate in the activities of Kookaburra Yoga. 

    By booking a retreat and participating in an activity with Kookaburra Yoga, you also agree to release Kookaburra Yoga, its staff, sub-contractors, volunteers, agents, leaders and all other parties associated with organising the retreat and activities from any responsibility or legal liability for death or personal injury associated with your presence at, and participation in, the activity.

    Kookaburra Yoga has made every effort, through its website, participant communications, and the Terms and Conditions of Participation to make you aware of potential risks and potential Injuries and Damages which can occur by natural causes or activities of other persons, animals, trip members, trip organisers, agents, leaders or third parties, either as a result of negligence or because of other reasons.

    Kookaburra Yoga, its organisers, staff, sub-contractors, volunteers and participants take no responsibility for you during the retreat and will not be held responsible for any injuries or accidents that may occur during the retreat, travelling to or from the retreat, the activities, and travelling to and from the activities. Outdoor activities are inherently dangerous and accidents do happen. You must exercise extra care for your own person and for others around you in the face of such hazards.

    It is a requirement of participating in Kookaburra Yoga’s international retreats that you have comprehensive Travel Insurance, and provide the certificate of currency to Kookaburra Yoga prior to travel. 

    It is a requirement of participating in Kookaburra Yoga’s Australian retreats that you have adequate health insurance, or the financial means, to cover the costs of any Injury or Illness which may occur during the retreat or as a result of your attendance at the retreat or participation in any of the retreat’s activities.

    It is a requirement of participating in any Kookaburra Yoga Retreat that you agree to the Terms and Conditions and that you 'sign' the Waiver of Liability by submitting the form on this page.

    WAIVER OF LIABILITY
    The waiver of liability is an agreement that attendance at the Kookaburra Yoga Retreat and participation in any Kookaburra Yoga activities are entirely voluntary and of my own choice and that you agree 100% to accept personal responsibility for all and any foreseen and unforeseen events that may occur during, including to and from, the retreat and the outings.

    DECLARATION
    I agree to the Terms and Conditions of Participation. I confirm my understanding that:
    1. Kookaburra Yoga does not certify or confirm the qualifications of any of the organisers, or staff, or volunteers, or sub-contractors, or agents to lead or manage or set-up activities nor are they trained to respond during an emergency by providing first aid, CPR, or any rescue action. I further understand that on these activities there may not be search, rescue, medical facilities or expertise necessary to deal with the Injuries and Damages to which I may be exposed.
    2. The activities officially begin and end at the location(s) designated by Kookaburra Yoga. I am personally responsible for all risks associated with travelling to and from the beginning and end points of the activities.
    3. If I decide to leave early and not to complete the activity as planned, I will immediately notify Kookaburra Yoga in person, and IO will assume all risks inherent in my decision to leave and waive all liability against Kookaburra Yoga arising from that decision. Likewise, if the leader has concluded the activity, and I decide to go forward without the leader, I assume all risks inherent in my decision to go forward and waive all liability against Kookaburra Yoga arising from that decision.
    4. I understand that physical activities involving physical exertion are part of a yoga and hiking retreat. I understand I should be in good general health, free from cardiovascular and respiratory disease, and have good exercise tolerance. If I have any prior knowledge of any physical or other issue which may affect my physical capacity to participate in the retreat activities, I agree to obtain my physician’s approval, and to disclose these issues to Kookaburra Yoga before commencing the activities.
    5. To the fullest extent allowed by law, I agree to WAIVE, DISCHARGE CLAIMS, AND RELEASE FROM LIABILITY KOOKABURRA YOGA, its officers, directors, organisers, employees, sub-contractors, agents, volunteers and leaders from any and all liability on account of, or in any way resulting from Injuries and Damages, even if caused by negligence of KOOKABURRA YOGA, its officers, directors, organisers, volunteers, employees, sub-contractors, agents, and leaders, in any way connected with this activity.
    6. I further agree to HOLD HARMLESS KOOKABURRA YOGA, its officers, directors, organisers, volunteers, employees, sub-contractors, agents, and leaders from any claims, damages, injuries or losses caused by my own negligence while a participant on the activities. I understand and intend that this assumption of risk and release is binding upon my heirs, executors, administrators and assigns, and includes any minors accompanying me on the activities.
    7. This Agreement is intended to be as broad and inclusive as is permitted by law. If any provision or any part of any provision of this Agreement is held to be invalid or legally unenforceable for any reason, the remainder of this Agreement shall not be affected thereby and shall remain valid and fully enforceable.
    8. By submitting this form and participating in the Kookaburra Yoga Retreat I freely and voluntarily assume all risks and damages associated with attending.

    I understand Kookaburra Yoga will not share any information contained in this form with any 3rd party without written or verbal permission from the signee. The exception to this is if there is a medical emergency and the retreat organisers deem it necessary, then details may be shared in this context only. 

    I agree to return this form prior to the retreat, and I understand it is a requirement to provide correct information in every field inthe following sections:
        3.1. Personal details
        3.2. Emergency Contact
        3.3. Release of Liability Agreement

    Cancellation & Refund Policy

    • ​Your booking and full payment confirms your place, meaning other people cannot book it. $400 is the non-refundable deposit portion of your payment.
    • ​If you cancel 0-2 weeks before the retreat the full amount of the retreat is payable.
    • If you cancel more than 2 weeks before the retreat your payment will be returned to you, minus the $400 non-refundable portion which will be retained.
    • ​If the organisers cancel the retreat the full amount will be refunded to you.
    By submitting this form I am agree to:
    • Terms and Conditions 
    • Cancellation and Refund Policy
    • Release of Liability of Kookaburra Yoga