Retreat Release Form


WE aim to provide A safe, relaxinG, and inspiring event for all. please read over this release and fill out the emergency contact info. Submitting the below information is considered signing this release form. 

I agree to waive, release, indemnify and hold harmless Stacy Green and Diane Pharo for any and all claims, demands, injuries, damages, actions or causes of action, suits, obligations or liabilities of any nature connected with my participation in the retreat.  I agree to be responsible for my actions at all times and agree that I assume certain risks by engaging in the retreat.


emergency contact INFO

Your Name *
Your Name