CONTACT
home
about
Our Yoga
Our Place
Our People
Calendar
Social
Gift Vouchers
retreats
About our retreats
Retreats Calendar
Sound Silence Stillness 1-Day
Bali Women's Yoga & Healing Retreat
Devotion Evening Retreat
Bluff Knoll Yoga & Hiking 3-Day Retreat
Blue Sky Mind 4 Day Meditation Retreat Margaret River
Sanctuary Women's 4 Day Retreat Margaret River
South India Devotion Retreat
Kookaburra Yoga Stay Personal Retreat
New Year's Eve Sound Silence Stillness Retreat
classes
About our Classes
timetable
Booking Calendar
Memberships & Passes
Weekly Classes
Monthly Classes
Private Classes & Counselling
Corporate & Private Groups
Teachers
courses
About Our Courses
Absolute Beginners Yoga
Yoga Relax Meditate Course
Introduction to Meditation
Yogic Living Cooking Course
training
Yoga & Meditation Teacher Training 2022-23
Yoga & Meditation Teacher Training 2024
events
Moksha World Yoga Day
home
about
Our Yoga
Our Place
Our People
Calendar
Social
Gift Vouchers
retreats
About our retreats
Retreats Calendar
Sound Silence Stillness 1-Day
Bali Women's Yoga & Healing Retreat
Devotion Evening Retreat
Bluff Knoll Yoga & Hiking 3-Day Retreat
Blue Sky Mind 4 Day Meditation Retreat Margaret River
Sanctuary Women's 4 Day Retreat Margaret River
South India Devotion Retreat
Kookaburra Yoga Stay Personal Retreat
New Year's Eve Sound Silence Stillness Retreat
classes
About our Classes
timetable
Booking Calendar
Memberships & Passes
Weekly Classes
Monthly Classes
Private Classes & Counselling
Corporate & Private Groups
Teachers
courses
About Our Courses
Absolute Beginners Yoga
Yoga Relax Meditate Course
Introduction to Meditation
Yogic Living Cooking Course
training
Yoga & Meditation Teacher Training 2022-23
Yoga & Meditation Teacher Training 2024
events
Moksha World Yoga Day
Participant Form
India Retreat 2016 Sept-Oct 2016
Please submit this form prior to attending retreat.
Personal Details
*
Indicates required field
Name
*
First
Last
Email
*
Mobile No. while in India
*
Submit photo of first page of Passport
*
Max file size: 20MB
Submit Insurance Certificate of Currency
*
Max file size: 20MB
Food allergies, dietary restrictions
*
Relevant medical history, any current medications, recent or past injuries
*
Emergency Contact Details
Name
*
First
Last
Phone Number (with country and area code)
*
Terms and Conditions
I understand and agree:
that my deposit is non-refundable and I have read and understand the Cancellation and Refund Policy.
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 (including coverage for trekking to 4000 metres)
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 at high altitude. In places the hikes are moderate and may be difficult depending on conditions. The onus is on me, the participant, to ensure that I am physically fit to undertake the activities.
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.
Kookaburra Yoga reserves the right to cancel the retreat. If this is to occur, Kookaburra Yoga will notify me in advance and give me a full refund within 30 days of cancellation.
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 preparations expenses.
Kookaburra Yoga shares information in this form and information collected from participants with third party tour organiser India Easy Pty Ltd.
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
The retreat deposit is non-refundable in the event of cancellation.
Cancellations within 2 weeks of departure (including no-shows) are liable for payment of the full retreat fee.
Cancellations made 2 weeks - 6 weeks prior to the retreat will receive a 50% refund of payments made (minus the deposit paid).
Cancellations made 6 weks or more prior to retreat will receive a refund of monies paid (minus the deposit paid)
If retreat organisers are able to offer the cancelled place to a wait-listed participant and successfully fill the place vacated, then all money paid (minus the deposit) will be refunded, regardless of when cancellation occurs.
If you cancel due to ill health or the death or il health of a family member your travel insurer may reimburse your travel costs (please check with your insurance company)
Retreat organisers reserve the right to cancel or postpone the retreat. Where the retreat is cancelled by the organisers, participants will be reimbursed their full retreat fee and provided with at least 3 months' notice.
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.
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 hiking and travelling components of 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 or on arrival.
By submitting this form I am agreeing to:
Terms and Conditions
Cancellation and Refund Policy
Release of Liability of Kookaburra Yoga
Submit