Health Questionnaire and Liability Waiver Form

In order to participate in our retreats, please complete and submit the health form below no later than two weeks prior to your retreat.

 

  • Personal

  • Health

    Please answer the questions below with as much detail as possible. If you answer YES to any of the questions, please provide further details, where applicable.
  • Additional

  • As guest of the Wild View Retreat, I hereby agree for this questionnaire to be held confidentially on file by Wild View Retreat for use by the retreat staff only, on the impending retreat and any future retreats.

    I also state that I wish to participate in activities, which may include aerobic exercise, resistance exercise and stretching, such as yoga, pilates, power walks, swimming, guided walks and hikes.

    If I have answered YES to any of the health related questions I hereby confirm myself fit or have sought my GP’s permission, to participate in the retreat activity outlined on the website.

    I confirm that I will notify Wild View Retreat of any changes in terms of my health and fitness mentioned in this questionnaire prior to participation on the retreat.

    I hereby state that I have read, understood and answered honestly the questions above.

    I understand that my participation in these activities involves the risk of injury and even the possibility of death. Furthermore, I hereby confirm that I am voluntarily engaging in an acceptable level of exercise, which has been recommended to me.