CLIENT WAIVER FORM
All clients are required to agree to the following Release and Liability Waiver which is effective for all Retreats and Sessions.
Please Initial each box to show your understanding
By signing below, I acknowledge and agree that:
( ) Practitioners at Vita wellness do not diagnose conditions, prescribe medications or provide medical treatments.
( ) The sole purpose of the sessions or Retreats are to assist in balancing, harmonizing, releasing and healing on all four levels. (physical, mental, emotional and spiritual)
( ) I assume sole responsibility for my own health and for the results of any sessions or Retreats provided by Vita wellness that may affect my health in any way.
( ) Treatments will not replace conventional medical diagnosis or treatment. I will continue taking medication prescribed by a licensed medical physician and will continue to follow his/her instructions.
( ) I release Vita wellness, its owners and practitioners from all legal liability during my participation in treatments.
( ) All information received by me from Vita wellness practitioners is accepted with full knowledge that any action taken by me as a result of the information received is my complete responsibility.
( ) If any disruptive, inappropriate, or mentally unwell behavior is displayed to the staff or other clients, to the point the retreat staff and coach cannot or is not qualified to contain, then you may be asked to leave from the program and referred to another facility or professional. Without repercussions towards Vita wellness or refunds of any kind.
( ) I understand that if I bring/consume any alcohol or drugs during my stay, no matter what, I take full responsibility and can be asked to leave early without any refunds.
( ) I understand that unless I have pre written consent and approval that I may not have visitors during my stay.
( ) I understand and agree that I must be sober of any drugs or alcohol for at least 14 days before attending or I will be asked to not attend or leave without any refunds and that Vita wellness is not a detox center.
( ) Disclaimer: I understand that if I attend (especially the Dependence behaviour reset retreat) that Vita wellness and its clinicians shall not be liable for any damages, claims, liabilities, costs or obligations arising from the use or misuse of substances or activities.
( ) I agree that Vita wellness is not responsible for any outcomes, relapses, or harm inflicted during or after my attendance of the retreat.
Vita wellness is committed to ensuring that the health information of our clients are treated with respect and safeguarded to ensure privacy.
( ) I understand that if I have any concerns about my Retreat I will contact and deal with Vita wellness office directly only, and that if I write any slander/negative comments online Vita wellness will be taking legal action for slander/damages. I understand that this applies to not only me but my family members and friends as well, including using a false name online.
( ) All Money received from the client can and will be dispersed by the company in different areas and used as per our discretion.
( ) I can confirm I am attending by my own free will.
( ) I understand that If all forms are not signed and sent back before my arrival the retreat will not be able to begin.
( ) I agree to all the rules stated in the information package and understand the repercussions if rules stated in the information package are broken. I give vita wellness the right to terminate service immediately with no refund or any financial or reputational damages if I the client break any of the rules stated in provided informational packages as well as all terms and conditions, information stated on the website, and policies provided in this waiver, the information package, and any other resources provided to me the client before, during and after my stay.
( ) I understand that all services and retreats are non-refundable.
( ) I agree that I am fully aware and agree to the total price of my retreat package and any additional services added on.
( ) I agree to let Vita Wellness keep my card on file for any additional services or incidentals.
( ) In the event that I have not remitted payment for this retreat, I hereby declare that I am speaking on behalf of the individual who has, and affirm that I have provided said individual with all pertinent information relating to the total cost of the retreat as well as the non-refundable policies associated therewith. Additionally, I solemnly commit that the aforementioned individual has authorized Vita wellness to utilize the payment card provided for the purpose of satisfying any outstanding balances.
Vita Wellness Retreat’s Policies
Cancellation Policy and Terms:
-
Vita wellness Retreats requires payment for the entirety of the Retreat at the time of booking and is non-refundable for any reason.
-
If there is an appropriate reason for needing to reschedule your retreat may be rebooked if asked for and approved at least 14-days prior to your Retreat date.
-
Once you cancel there will be NO window to reschedule, rebook, or to transfer. And no refunds will be given for any deposit or payment made for any reason.
-
All pre-booked services are Non-refundable.
-
Retreats are only valid to book or rebook for up to one year from the purchase date.
-
Please be aware that we do not give out itemized invoices, as the price is a package total and insurance companies do not cover our packages so we cannot supply itemized invoices to them. A paid invoice can be requested and can be sent after your retreat.
---------------------------------------------------------------------------------
Fees:
1. Gratuity, Credit card, and Tax fee of 15% will be charged on the total retreat amount.
2. For any date changes made a $250 fee will be applied.
3. If Retreat is booked on a Holiday or long weekend a 3% fee will be added.
4. Please be aware that if staying for a week or more a 10% gratuity fee will be added instead of 5%
Additional Services:
If you add any additional services to your retreat during your stay, you will be required to pay for them at the end of your retreat along with all taxes, gratuity and CC processing fees. Any services that are not listed on your original Itinerary are considered additional services.
If you contact your coach for additional coaching sessions outside of the allotted work hours shown on your itinerary, unless for an emergency, additional fees may be added.
Early Check-out
If you choose to leave early, (FOR ANY REASON) there will be no credits, no refunds or transferrable days. You cannot transfer any remaining days to somebody else.
Late Check-Ins Policy:
Your reservation will only be held up to 1 hour from your check-in time unless special requests have been made prior to your retreat.
Late Check-Outs Policy:
Late check-outs after 12:00 pm is a $60 fee, if able to accommodate.
Early Check-in Policy:
Early Check-in/pick up $100 fee is applied anytime if you need to check-in or need to be picked up before 2:30pm, if able to accommodate.
No show or Late Policy:
If you are not there or are late to your scheduled services during your retreat a fee will be added.
Following the pronouncements above I hereby declare the following:
- I am fully and personally responsible for my own safety and actions while and during my participation and I recognize that I may be in any
the case at risk of contracting COVID-19 or any other illness.
- With full knowledge of the risks involved, I hereby release, waive, discharge the Organization, its board, officers, independent contractors,
affiliates, employees, representatives, successors, and assigns from any and all liabilities, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, injury, or death, that may be sustained by me related to COVID-19 or any other illness while participating in any activity while in, on, or around the premises or while using the facilities that may lead to unintentional exposure or harm due to COVID-19 or any other illness.
- I agree to indemnify, defend, and hold harmless the Organization from
and against any and all costs, expenses, damages, lawsuits, and/or liabilities or claims arising whether directly or indirectly from or related to any and all claims made by or against any of the released party due to injury, loss, or death from or related to COVID-19 or any other illness.
---------------------------------------------------------------------------------------
By signing below I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am at least eighteen (18) years old and fully competent to give my consent; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation.
II. LIABILITY EVENT. Under the terms of this Release and sufficiency of which is hereby acknowledged, the Releasor hereby releases and forever discharges the Releasee: Vita wellness Retreat (“Liability”).
THEREFORE under the terms of this Agreement and sufficiency of which is hereby acknowledged, do hereby release and forever discharge the Releasee including their agents, employees, successors and assigns, and their respective heirs, personal representatives, affiliates, successors and assigns, and any and all persons, firms or corporations liable or who might be claimed to be liable, whether or not herein named, none of whom admit any liability to the undersigned, but all expressly denying liability, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, which now have or may hereafter have, arising out of or in any way relating to any and all injuries and damages of any and every kind, to both person and property, and also any and all injuries and damages that may develop in the future, as a result of or in any way relating to the Liability.
