The Pilates Lady Retreat Participation & Consent Form

Santa Cesarea Terme

Please read carefully and complete before attending the retreat.

I confirm that:

I am voluntarily participating in activities during this retreat including Pilates, yoga, walking, swimming, mobility sessions, face yoga, wellness activities, excursions and related experiences.
I understand that these activities involve physical movement and carry a small risk of injury, falls, muscle soreness, fatigue or other health complications.
I confirm that I am physically and medically fit to participate.
I have disclosed any relevant medical conditions, injuries, allergies, medications or concerns that may affect my participation.

I understand that the retreat includes a coastal walk involving:

I acknowledge that:

I understand weather or local conditions may require activities to be adjusted or cancelled.

I understand that the retreat may include:

I agree to participate within my own comfort and ability levels and to inform the retreat host if I feel unwell or unable to continue.

I understand that I am responsible for:

I understand that participation in all activities is optional.

To the fullest extent permitted by law, I release and hold harmless The Pilates Lady / Emma Lynas from liability for:

except where caused by negligence.

First name

Last name

Address & Phone Number

Date of Birth

Day

Month

Year

Emergency Contact Name & Phone Number

Medical conditions/injuries/allergies to declare:

Photography & Social Media

I am happy for photographs/videos taken during the retreat to be used for marketing/social media purposes.

Please do not use photographs/videos of me.

I confirm that:

I have read and understood this form.

I voluntarily agree to participate in retreat activities.

All information provided is accurate to the best of my knowledge.