GENERAL MEDICAL WAIVER AND RELEASE OF LIABILITY FORM
I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES being conducted by Hacienda Del Sol, San Juanillo, Costa Rica.
I CERTIFY that I am physically fit, have sufficiently prepared for participation in this retreat, and have not been advised to not participate by a qualified medical professional. I also understand that I am fully responsible to consult with my doctor before participating in such
activities.
I CERTIFY that there are no health-related reasons, medications, or problems which preclude my participation in this retreat.
I AGREE to fully comply with the applicable rules, policies, and instructions given to me by Hacienda Del Sol staff regarding participation in any activity.
I ACKNOWLEDGE that I will provide Hacienda Del Sol with all medical information they ask of me that is relevant to my retreat in advance of the start of my retreat.
I UNDERSTAND that Hacienda Del Sol is not a medical facility, does not offer medical advice, and does not have medically trained staff.
I UNDERSTAND that Hacienda Del Sol is is not responsible or liable for any medical complication resulting from participating in any retreat or activity at Hacienda Del Sol.
I UNDERSTAND that Hacienda Del Sol is 3 hours from the closest hospital and 45 minutes from the closest clinic.
In the event that I should require medical care or treatment, I authorize Hacienda Del Sol to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel.
I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment.
I am aware and understand that I should carry my own health insurance that covers my stay in Costa Rica.
In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(1) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: Hacienda Del Sol, San Juanillo, Costa Rica, and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;
(2) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise.
I acknowledge that Hacienda Del Sol and their directors, officers, volunteers, representatives, and agents are NOT responsible for errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that any retreat may have risks. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, lack of hydration, and actions of other people, including, but not limited to, guests, staff, and/or facilitators of the resort. This Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.
I CERTIFY that I have read this document and I fully understand its content. I am aware that this is a release of liability and a contract, and I sign it of my own free will.
