Lisa Warren Yoga Retreats

Yoga-ez top

Please pay for retreat here - full/deposit here
(This will open up a new page leaving this form on the screen to complete after payment is made) - then complete the form below.
It is important that you read and agree (box supplied) to terms and conditions/liability waiver as set out here
Thanks

Summer Retreat Chang Mai

Please note that all fields followed by an asterisk must be filled in.

First Name*
First Name*

Last Name*
Last Name*

E-mail Address*
E-mail Address*

Street Address*
Street Address*

City*
City*

State/Prov*
State/Prov*

Zip/Postal Code*
Zip/Postal Code*

Country*
Country*

Home Phone

Business Phone

Fax

Accomodation:*
Accomodation:*
One Star Single @ £600.00 ($1185)
One Star Double/Twin @ £580.00 ($1145)
Two Star Single @ £705.00 ($1388)
Two Star Double/Twin @ £608.00 ($1205)
Three Star Single @£730 ($1445)
Three Star Double/Twin @ £628.00 ($1240)

I have paid:*
I have paid:*
Full Amount
Deposit
Not paid yet

I plan to arrive on (day/month)*
I plan to arrive on (day/month)*

I plan to depart on (day/month)*
I plan to depart on (day/month)*

I have read and agree the terms and conditions of payment and deposit*as on retreat page
I have read and agree the terms and conditions of payment and deposit*
I have read and agree

I have read and agree to Limitation of Liability as set out below*

I have read and agree to limitation of Liability as set out below*

I agree to Limitation of Liability and agree this consent acts as my electronic signature

Full Name as in Passport

Passport number and country of issue

Date of Birth

My dietary restrictions are:

I am :*
I am :*
in good to excellent health
not in good and excellent health(I specify below)
in good to excellent fitness
not in good to excellent fitness(I specify below)

Health particulars from above are:

I agree to the following:*
I agree to the following:*
I have purchased travel health care insurance (compulsory)
I have consulted my doctor concerning my own medical requirements
I agree with the terms and conditions and fee structures
I have agreed with the cancellation policy

Other useful information you wish to share

This is my name (or parent/guardian for under 18s)*

Below is my name (or parent/guardian for under 18s)*

I agree to all terms and the underticked box is my electronic signature to agreement dated the date on this form send*
I agree to all terms and the underticked box is my electronic signature to agreement dated the date on this form send*
I agree and make this my electronic signature

Please enter the word that you see below.

Read the following carefully and sign above with electronic signature:

You are required to purchase your own personal, medical and travel insurance. You need to be in sound health, be
responsible for your own general welfare and have an active sense of responsibility for yourself and others in the group.
Please check with your doctor for any medical requirements.

ALSO:
LIMITATION OF LIABILITY

These paragraphs define our responsibility with respect to our journeys and contracted services. Please read carefully.
Your signature above represents acceptance of the following terms and conditions.

I will not hold Tao Retreats or their agent in this instance Living Zen/ Yoga-ez liable for loss or damage to baggage or property or for personal injury or death resulting
from acts, omissions, or negligence of any provider of services or accommodations or due to other causes beyond the control of Tao Retreats, or for loss or additional expenses or inconvenience resulting from acts or omissions of any carrier or any other supplier of services or facilities, or delays, cancellations, re-routings and any other action caused by weather, political disturbances, strikes, lockouts, riots, war, terrorist actions, insurrections or any other reason. Tao Retreats may, in its sole discretion, cancel or change the schedule of all or any part of any program or extension if it considers such action to be in the general interest of participants or their safety, and I waive all claims against Tao Retreats arising from such actions or decisions. Tao Retreats reserves the right to alter the itinerary when necessary. All prices quoted are valid at the time of publication and every effort is made to honor the original published pricing; extraordinary circumstances may warrant revisions and Tao Retreats reserves the right to revise final pricing when necessary.

I undertake the following obligations. To declare any known illnesses or pre-existing health conditions and to seek medical assurance that it is safe to partake in a journey of this nature; To sign this legal waiver prior to the commencement of services contracted; To carefully review all information furnished about the requested journey; To properly equip myself for the journey; To respect the customs of areas visited and to refrain from antisocial conduct during the trip; To always respect the rights and privacy of other participants. At Tao Retreats' discretion a participant may be asked to leave the tour or may be disallowed from attending specific segments of the tour if Tao Retreats deems participation to be potentially detrimental to the group or to the individual participant.

Cancellation Policy: Refunds prior to February 1, 2008 will incur a £250/$500 cancellation fee. After that, refunds will be made only if a replacement can be found. Any deposit made is non refundable. Full payment required by April 1st 2008. This policy is firm. We strongly recommend the purchase of adequate travel insurance.

I, the undersigned will not hold Tao Retreats or their officers or agents responsible for any losses or expenses incurred resulting from cancellation of my trip, accident, sickness, stolen or damaged baggage, any default of a common carrier (air line, train, bus, etc.) whether it be a result of insolvency, bankruptcy, or another financial difficulty, or resulting from any other travel supplier-related problem.

My electronic signatures above are agreed by me to be compliance with these conditions and terms