South India Retreat Participation Form

Participant Form
South India Devotion Retreat

Completing this form is compulsory for all participants attending the India 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 *

Date of Birth *

Flight Details

Arrival Flight Number *

Arrival Flight Time & date *

Departure Flight Number *

Departure Flight Time & Date *

Extra nights

Are you arriving earlier than tour start date? *

yes no

Are you departing after tour end date? *

yes no

Date of arrival *

Date of Departure *

Emergency Contact Details

Name *

First

Last

Phone Number (with country and area code) *

Any additional information

Comments *

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.
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 is not 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.
Kookaburra Yoga shares information in this form and information collected from participants with third party travel agent in India for the purposes of organising transfers and booking accommodation.
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

There is an initial $1490 payment upon booking. The non refundable deposit portion of this is $700. This is your commitment to attend and is generally nonrefundable unless we can offer your place to a waitlisted person or you find someone to take your place.
In exceptional circumstances we may refund part of the deposit to you. Even then only the unused portion of the deposit is refundable (we book accommodation, transport etc as soon as you register to secure seats)
If you cancel 0-8 weeks before the retreat the full amount is payable.
If you cancel 8-12 weeks before the retreat 50% of the retreat fee will be refunded to you.
If you cancel more than 12 weeks prior to the retreat your full payment (except for the 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.
Travel insurance on this retreat is compulsory.
If Kookaburra Yoga cancels this retreat 12 weeks or more prior to the commencement date all monies paid will be refunded within 30 days.
If Kookaburra Yoga cancels this retreat due within 12 weeks of the tour commencement date due to a natural disaster or unforeseen acts of God, full refunds may not be possible. Please ensure you have adequate travel insurance.
Ensure you organise travel insurance as soon as you book. Your insurance policy should cover you in the event you are unable to travel or need to cancel due to unforeseen circumstances. Please check your policy carefully to ensure you have suitable cover.

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 sightseeing 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.

By submitting this form I am agreeing to:

Terms and Conditions
Cancellation and Refund Policy
Release of Liability of Kookaburra Yoga

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Participant Form​ South India Devotion Retreat