Reconnect | Rejuvenate Retreat Agreement

RYANA YUSOFF COACHING

Agreement and Disclaimer Form for Wellness Retreat

Welcome to our wellness retreat. We are excited to have you here with us. Before

you participate in any activities or services provided by our retreat, please read and

sign this agreement and disclaimer form

Agreement:

1. I acknowledge that participation in the wellness retreat and its activities may

involve physical activity, including yoga, hiking, and other exercises that may

cause physical strain on my body. I understand that it is my responsibility to

inform the retreat staff of any physical limitations or health concerns before

participating in any activity.

2. I agree to follow all safety instructions and protocols provided by the retreat

staff during the retreat. I understand that failure to follow safety instructions

may result in my exclusion from participating in the activities.

3. I acknowledge that the retreat may have a no refund policy, or if available, it

will be a refund via credits for future wellness services provided by Ryana

Yusoff and I agree to make full payment for the retreat before my arrival.

4. I give permission for the retreat staff to take photographs or videos of me

during the retreat and understand that these may be used for promotional

purposes. I will notify the staff should I prefer not to be photographed.

5. I agree to respect the privacy and boundaries of other participants during the

retreat.

Disclaimer:

1. I acknowledge that the wellness retreat is not a substitute for medical or

psychological treatment or advice. I understand that it is my responsibility to

consult with my healthcare provider before participating in any activities at the

retreat.

2. I acknowledge that the retreat staff are not responsible for any injuries or

illnesses that may occur during my participation in any activities or services

provided by the retreat.

3. I understand that the retreat staff may modify the activities or schedule for the

retreat for any reason, including weather conditions, participant limitations, or

other unforeseen circumstances.

4. I acknowledge that the retreat staff are not responsible for any loss, damage,

or theft of personal belongings during my stay at the retreat.

5. I agree to release and hold harmless the retreat staff and their respective

affiliates, employees, and agents from any claims, damages, or losses arising

out of my participation in the wellness retreat.

6. I understand that I am responsible for obtaining my own travel and medical

insurance, which should cover any potential injuries, illnesses, flight

cancellations, or unforeseen circumstances that may occur before, during, or

after the retreat. I acknowledge that the retreat organizers and staff are not

liable for any costs or losses related to such situations.

I have read and understood the above agreement and disclaimer and agree to abide

by them. I acknowledge that by signing this form, I am assuming the risks of

participating in the wellness retreat and its activities.

Name: ________________________________________________

Signature: ________________________________________________

Date: ________________________________________________

Facilitator’s Signature:

Name: Hariyana Yusoff

The Eclectic Space – UEN53372219E

Date: 16/10/25

Client Information:

Full Name: ________________________________________________________________________

Date of Birth: _____________________________________________________________________

Phone Number: ____________________________________________________________________

Email Address: _____________________________________________________________________

Emergency Contact: ________________________________________________________________

Medical History: __________________________________________________________________