Shivananda Swamiji Waiver & Release

Event | Retreats (including Private Healing Sessions)

Please complete and check all four fields on the form, otherwise the form is invalid. Thank you!

 

*Use of term Organizer (s) includes (and is not limited to, see declaration below for full details):

Shivananda Swamiji (Francesco Grassi), Shivananda Ashram City of the New Light (Aps-asd),

and Shivananda New Light Collective Inc.

*Use of the term ‘Event|Retreat” includes (and is not limited to) ALL Event|Retreat Activities

(listed below) and Private Healing Sessions.


 

Name of Retreat (if visiting outside of Event|Retreat, please write “Ashram Visit”):

Submitted form is valid as a signature.


Event|Retreat Activities: (may include but are not limited to) Participation in: Darshan, Fire Puja, Private Healing Sessions, Yoga, Meditation, Ecstatic Movement, Bhajan, Energy Healing, Energy Activations, Kundalini Awakening, Sadhana, Kriya, Pranayama, Karma Yoga (cleaning, cooking, preparing ceremonies, etc.), Abiseckam, Cacao Ceremony, Rapé Ceremony, Creative Arts & Healing Laboratories, Shakti Pat, Sharing Circles, Visiting Temples/Sacred Sites, Sacred Ceremonies and more.

Location: Shivananda’s Ashram ~ Agriturismo Avellaneta, SP1 7KM Contrada Avellaneta, San marco LA Catola, 71030 Italy

Organizer Name: Shivananda Ashram City of the New Light Aps-asd

Business Address: Contrada Avellaneta Sp1 localitĂ  San Cristoforo , San Marco la Catola 71030

Business Contact: [email protected]

 

Declaration

 

I, signed below, hereby agree that by signing this document, I consent to waive certain legal rights, including the right to sue the above-mentioned Organizer (s) and, if applicable, its employees, owners, officers, directors, representatives , volunteers and facilitators from any physical, emotional, mental, spiritual, material, tangible or intangible loss or damage that may occur to me during my participation in the Event|Retreat. I take full and personal responsibility for the possible physical, emotional, and mental effects of such a Event|Retreat, relieving the Organizer (s), acknowledging and being aware that the topics covered during the Retreat are a personal opinion of those who will conduct the activities.

I will voluntarily participate in the Event|Retreat which will be conducted by the Organizer (s). The Event|Retreat may include, but is not limited to, the “Event|Retreat Activities” described above.

The following is the identifying and contact information for me, the Guest (“Guest”):

Submitted form is valid as a signature.

This Event|Retreat Waiver & Release will bind and be enforceable against me and all of my personal representatives. I agree that this Event|Retreat Waiver & Release shall be enforceable to the fullest extent permitted by law, and if any portion is deemed invalid, the remainder shall continue to have full legal force and effect.

I specifically acknowledge and agree that this document is not intended to be a general release, which would be limited by certain state and local laws. This Event|Retreat Waiver & Release shall be construed and interpreted as broadly as possible in the applicable jurisdiction.

NOT MEDICAL SUBSTITUE/ADVICE. Shivananda Swamiji and the Event|Retreat do not provide any medical or professional advice. Anything said should NOT be taken as a replacement for medical, clinical, professional advice, diagnosis, or medical intervention. If you take any action or inaction as a result of any of the content you consume, this is based solely on your decision, and the Organizer(s) cannot be held liable for any of the consequences of such action or inaction. If you choose to contact the Organizer(s) to provide personal or medical information, this does not create a clinician-patient relationship between you and the Organizer(s). Nothing in the Private Healings and Event|Retreat is intended to establish a clinician-patient relationship, to replace the services of a trained therapist, doctor or health professional, or otherwise to substitute for professional mental health, medical advice, diagnosis or treatment.

ASSUMPTION OF RISK. I understand and am aware that my participation in the Event|Retreat involves risks. These risks can lead to tangible or intangible harm, and I agree that they can result not only from my actions but also from the actions of others. With knowledge and understanding of these risks, I choose, of my own volition, to participate in the Event|Retreat. I am also aware that there are risks that I may not have considered, however I waive my right to any claims that may occur from these risks unconsidered, and I choose, of my own free will and volition, to participate in the Event|Retreat.

PHYSICAL CONTACT. Because I and the Organizer (s) work together to explore the self as a whole and are focused on increasing awareness of the mind/body/spirit connection, activities may involve moments of physical contact. This contact may come in the form of touch, being physically supported, or held in a manner that is meant to increase understanding of the self and which may potentially provide a healing experience. I give advanced consent and permission for this touch offered. I understand the touch I receive and carry out is never sexual and is always done with the utmost integrity and respect. I have complete control over whether touch seems like it may be helpful in the activities and have the right to refuse this element at any time, without need of explanation, fear or concern of a negative response or reaction of the Organizer(s). I understand touch can be very beneficial but can also unexpectedly evoke emotions, thoughts, physical reactions, or memories that may be upsetting, depressing, evoke anger, etc.

If such a process arises, I take complete responsibility for seeking support and professional help. Safety is of utmost importance. As such, any act of aggression to self, others, or property while on site may be grounds for compensation for damages, legal action and/or immediate termination of services. The Organizer (s) do not take any legal responsibility for any touch offered by other participants.

Signed with a form, I consent to the use of touch in activities and healing sessions, and I will make concerns known to the Organizer (s) if they arise. I may refuse touch or revoke consent at any time and will notify the Event|Retreat staff immediately if I choose.

PHYSICAL AND MENTAL HEALTH REQUIREMENTS. By signing up for the Event|Retreat, I attest that I am in good physical, emotional, spiritual, and mental health to travel and participate in the Event|Retreat.

The Organizer(s) advises you to consult with a physician/ medical health care professional to ensure you are in adequate health.

CONFIDENTIALITY. This Agreement is considered a mutual non-disclosure agreement. Both Parties agree not to disclose, reveal or make use of any information learned by either party during discussions, activities, or otherwise, throughout the term of this Event|Retreat. Confidential Information includes, but is not limited to, information disclosed in connection with this Agreement, and shall not include information rightfully obtained from a third party.

CLIENT RESPOSBILITY | NO GUARANTEES. I accept and agree that I am 100% responsible for my progress and results from the Event|Retreat. The Organizer (s) will help and guide; however, participation is the one vital element to the Event|Retreat’s success that relies solely on myself. The Organizer(s) makes no representations, warranties, or guarantees verbally or in writing regarding my performance, growth, and effects. I understand that because of the nature of the Event|Retreat and extent, the results experienced by each person may significantly vary.

FINANCIAL DAMAGES. I am financially responsible for any damages that I create at the Shivananda’s Ashram and/or Event|Retreat sites.

CANCELLATIONS. *31+ days from the Event|Retreat start date: The deposit is non-refundable. If you have already paid the full fee, you will receive a refund minus the non-refundable deposit.

0-30 days from the Retreat start date: The booking at this stage is non-refundable and cannot be transferred to another date.

*For Private Healing Sessions the cancellation policy states +48 hours from the Session start date: If you have already paid the full fee, you will receive a full refund.

0-48 hours from the Session start date: The booking at this stage is non-refundable and cannot be transferred to another date.

Refunds cannot be made:

If your transport (train/air etc.) is cancelled

No-shows, i.e. you don’t cancel, and you don’t let us know that you won’t be attending

Any illnesses —> please purchase appropriate travel insurance to protect your investmentWe reserve the right to cancel the retreat for any reason. This would only happen in exceptional circumstances resulting in us not being able to offer the retreat as advertised, or if the minimum number of participants to run the retreat is not met. Should this happen, we will notify you as soon as we have knowledge of the cancellation and will refund you the full amount you paid us in respect of the Event|Retreat. We cannot be held liable for any expenses which you may have incurred, such as travel, holiday days or exchange rate losses.

INDEMNIFICATION: I agree to defend and indemnify the Organizer(s) and all of its affiliates (if applicable) and hold them harmless from any and all legal claims and demands, including reasonable attorneys' fees, that may arise from or relate to my participation in the Event|Retreat or my conduct or actions. I agree that the Organizer shall be able to select its own legal counsel and may participate in its own defense if desired.

REPRESENTATION: I am over 18 (eighteen) years old and I am emotionally, medically, spiritually and physically capable of attending the Event|Retreat.

GOVERNING LAW: This Retreat Waiver shall be governed by and construed in accordance with the internal laws of Italy and California without giving effect to any choice or conflict of law provisions or rules. Each party hereby irrevocably submits to the exclusive jurisdiction and venue of the federal and state courts located in the following county in any suit, action or proceeding arising out of or based on this Recall Waiver: San Marco La Catola Foggia and San Diego.

I have read the above Event|Retreat Waiver & Release fully and I understand and agree its contents. I understand and agree that by signing this Retreat Waiver I forfeit any right, claim or ability to hold the Organizer(s) responsible for any tangible or intangible damage, loss of property or loss of life that may occur during or after my use of the facilities and participation in the Retreat.

 

Date: [Valid date of this document is when the form is submitted]

Signature: [Valid signature with submitted form]

 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

For Shivananda New Light Collective Administration Only:

Date Collected: _____________________________________

Shivananda Swamiji Signature:  ____________________


 

For Events | Retreats Held In the EU

INFORMATION TO THE PERSON CONCERNED FOR THE PROCESSING OF PERSONAL DATA

in accordance with

of D. Lgs 196/2003 and subsequent amendments

Of the General Data Protection Regulation - EU Reg. 2016/679

 

In compliance with the provisions of the European Regulation 2016/679 (abbreviated as GDPR), we would like to inform you that the personal data you have provided or that we have acquired within the scope of our activity, which are necessary to execute the services offered, will be processed in accordance with the regulations on privacy and the principles of fairness, lawfulness, transparency and protection of your confidentiality and your rights.

Data Controller: the Data Controller is Francesco Grassi, born in Putignano (BA) on 12.06.1975;

- purpose of processing: the personal data you provide are necessary for the performance of activities and services offered in the Ashram;

- provision of data, refusal and revocation: the provision of your personal data is necessary for the purpose of carrying out the activities referred to in the preceding point, and any manifestation of refusal (or revocation of consent) to the processing will result in the impossibility of carrying out the same activities;

- methods of processing and storage: processing will be carried out in analogue (paper) and digital form (by means of electronic devices), in compliance with the provisions of art. 32 GDPR 2016/679 on security measures, by the Data Controller and/or specially appointed persons and in compliance with the provisions of art. 29 GDPR 2016/679; in compliance with the principles of lawfulness, purpose limitation and data minimization, in accordance with Art. 5 GDPR 2016/679, subject to the free and explicit consent expressed at the foot of this notice, your personal data will be processed and stored for the time necessary for the achievement of the purposes for which they are conferred and, in any case, for the period of time required by law;

- scope of communication and dissemination: the data collected will not be disseminated and will not be disclosed without your explicit consent;

- transfer of personal data: your data will not be transferred to member states of the European Union or to third countries outside the European Union; should the need arise, the Data Controller will ask you to give explicit consent;- special categories of personal data: in accordance with Articles 9 and 10 of the EU Regulation 2016/679, You may provide data qualifying as "special categories of personal data" (formerly "sensitive data"), i.e. those data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, trade union membership, as well as genetic data, biometric data intended to uniquely identify the person, data relating to health or sexual life or sexual orientation, data concerning criminal convictions, crimes or security measures. Such data may be processed only with your free and explicit consent, given in writing at the foot of this notice;

- Rights of the data subject: at any time, you may exercise, pursuant to Articles 15 to 22 of EU Regulation 2016/679, the right to:

(a)request confirmation of the existence or non-existence of their personal data;

(b)obtain information about the purposes of the processing, the categories of personal data, the recipients or categories of recipients to whom the personal data have been or will be disclosed, and, when possible, the retention period;

(c) obtain rectification and deletion of data;

(d)obtain restriction of processing;

e) obtain portability of data, i.e., receive them from a data controller, in a structured, commonly used, machine-readable format, and transmit them to another data controller without hindrance;

f) object to the processing at any time and also in the case of processing for direct marketing purposes;

(g) object to automated decision-making related to physical individuals, including profiling;

h) request from the data controller access to and rectification or erasure of personal data or restriction of processing concerning him or her or to object to its processing, as well as the right to data portability;

(i) withdraw consent at any time;

(j) propose complaints to a supervisory authority.

The rights under (a) to (i) are exercisable through a written request sent to the Holder.

I, the undersigned, in light of the information received,

I declare that I have read and understood:

I declare that I have read and accepted the regulations. Submitted form is valid as a signature.

to the processing of my personal data

I declare that I have read and accepted the regulations. Submitted form is valid as a signature.

Contact Us

If you have any questions, concerns or complaints about this Shivananda Swamiji Waiver & Release, please contact us by email: [email protected]