Liability Waiver Portugal Retreat

return to yourself retreat portugal 2025

LIABILiTY WAIVER

Please fill out the following questionnaire, sign the liability release form ASAP so we can ensure your needs are taken care of upon your arrival.

Name *

First

Last

Email Address *

Emergency Contact: (Name/Phone number) *

Flight Information: Arrival Time and Flight Number (Please arrive to Shamballah Retreat Center by 2pm April 21th)

You are responsible for purchasing your own traveler’s insurance & providing any proof of good health that is required to enter the country (if need restrictions apply at that time)

Flight Information: Departure Time and Flight Number

Please list any dietary restrictions:

Please list any injuries or other issues that may affect the physical, emotional, and spiritual work we may offer during this retreat: *

Please list any allergies (including medications in case you need to see a professional):

Please list your EU or US ring size: *

Find out what your size is: https://solspel.com/ring-size-chart/

What do you hope to get out of this retreat? *

Is there something you would like to work on in particular during the retreat? *

What issue in your life has been the biggest impact on you? *

What was the most challenging issue/struggle for you in your childhood? *

If you could name the biggest recurring family pattern within your family of belonging what would this be? For example; money issues, poverty, health issues, death, addictions, mental health issues, secrets, abuse. *

Liability Waiver *

YES
Other

I am aware that nOMad always at OM and Tamara Ardeljan and Marie & Martin Richtsfeld are here to serve me by sharing knowledge of family constellations, wellness, yoga, sound, somatic, and alchemy practices. I understand that the practices and activities on this retreat involve physical movement that at times can be strenuous, and when not practiced mindfully can put me at risk of injury. I understand that I am responsible for myself and will not exceed my own limits that may put others or myself in danger. I acknowledge that I must consult a doctor before practicing yoga/movement if I have any medical condition. I understand that in order for my teacher to serve me better and not put me at risk of injury, that I will disclose any injuries/conditions before this retreat begins. If I do not wish to receive such adjustments, it is my responsibility to share this with the teacher at the beginning of a class. I also understand there might be conversations and inquiry that will be a part of the retreat, that may trigger past feelings and circumstances that may be challenging to sit with. The retreat leaders are not therapists, and do not diagnose or treat conditions. If I have been diagnosed or in treatment for a mental health-related condition in the past, I know that I need to consult my therapist or professional to continue with that treatment and inform your retreat leaders if there is any area of concern with regard to the work we will undertake during the retreat. I am aware of the practices being offered are quite detoxifying for the various physical and energetic systems. I have consulted with my doctor about any surgery or vaccines and cleared my schedule of them at least 2 months prior to the retreat to avoid any adverse reactions." By entering into this relationship, I understand and acknowledge that I am solely responsible for my own choices, and that no guarantees or outcomes are being promised as a result of our work together. I hereby waive and release any claim that I may have at any time for injury, distress, or any sort against nOMad always at OM, Tamara Ardeljan, Marie & Martin Richtsfeld, or any person or entity in any way involved therewith, including without limitations its principals, teachers, employees, and representatives. I am aware that any employee of nOMad always at OM, Tamara Ardeljan, Marie & Martin Richtsfeld, or Shamballah Retreat Center are not responsible for any personal property, any lost or stolen items, or personal injury/death while traveling to and from or while on the property. I have purchased my own traveler’s insurance, "cancel for any reason" within 21 days of payment and waive any responsibility of nOMad always at OM, Tamara Ardeljan, or Marie & Martin Richtsfeld to cover any travel expenses in the event that the flights are canceled or rescheduled due to reasons by the airlines. In the event that the retreat needs to be cancelled, nOMad always at OM will refund all payments, as per our agreement, already paid to nOMad always at OM. All other expenses are my own responsibility. I am covered by health insurance, I have traveler’s insurance, and waive any responsibility of nOMad always at OM and Tamara Ardeljan and Marie & Martin Richtsfeld in the case that I need to receive professional help during the retreat. I have carefully read, fully understand and agree to the above. By checking "Yes" below I agree to all of the above.