SayPro Medical and Health Waiver for Monthly Wellness Retreats.

The SayPro Monthly Wellness Retreats, including the January SCDR-4 retreat, are designed to provide a holistic and enriching experience for all participants. However, to ensure that the retreat activities are conducted in a safe environment, it is essential to obtain information about participants’ health conditions, physical limitations, and dietary needs. This information will help retreat organizers make any necessary accommodations and ensure that all activities are safe for each individual.

The Medical and Health Waiver is a legal document that acknowledges the participant’s health status and any conditions that might impact their ability to engage in certain activities. It also serves as a waiver of liability, indicating that the participant understands the risks associated with attending and engaging in retreat activities.

Below is the detailed SayPro Medical and Health Waiver that participants will need to complete before the January SCDR-4 Wellness Retreat.

SayPro Monthly Wellness Retreat Medical and Health Waiver Form

1. Participant Information

1. Full Name:
   • First Name: ___________________________
   • Last Name: ___________________________
2. Employee ID (if applicable): ___________________________
3. Email Address:
   • Preferred email for retreat-related communications: ___________________________
4. Phone Number (in case of emergency): ___________________________

2. Health Considerations and Disclosure

This section aims to gather critical health information to ensure the safety of all participants during the retreat. All information will be kept confidential and used only for safety purposes during the retreat.

1. Do you have any existing medical conditions or chronic health issues that may affect your ability to participate in the retreat activities (e.g., cardiovascular conditions, respiratory issues, mobility limitations, etc.)?
   • Yes
   • No
   • If yes, please specify: __________________________________________________________
2. Do you have any physical limitations or injuries that may impact your ability to engage in physical activities during the retreat (e.g., yoga, fitness sessions, nature walks)?
   • Yes
   • No
   • If yes, please specify: ___________________________________________________________
3. Do you currently take any medications that may affect your participation in activities, especially those involving physical exertion or stress?
   • Yes
   • No
   • If yes, please list the medications and their intended use: ___________________________________
4. Do you have any allergies or sensitivities that we should be aware of during the retreat (e.g., food allergies, medication allergies, environmental allergens)?
   • Yes
   • No
   • If yes, please specify: ___________________________________________________________

3. Physical Activity and Exercise Acknowledgment

The wellness retreat will include various physical activities such as yoga, fitness exercises, nature walks, and stretching routines. This section ensures that participants are aware of the physical demands of these activities and are physically able to participate.

1. I understand that the retreat may include moderate to intense physical activities, including yoga, walking, stretching, and fitness exercises, and I acknowledge that it is my responsibility to inform the retreat organizers if I have any physical limitations or health conditions that might prevent me from safely participating in these activities.
   • I Agree
   • I Do Not Agree
2. Do you have any conditions that may affect your ability to engage in physical exercise or fitness activities during the retreat (e.g., joint pain, back problems, respiratory issues)?
   • Yes
   • No
   • If yes, please specify: ___________________________________________________________
3. Are there any physical activities you feel unable or unwilling to participate in?
   • Yes
   • No
   • If yes, please specify: ___________________________________________________________

4. Dietary and Nutrition Considerations

During the retreat, meals will be provided, and it is important to accommodate any dietary restrictions to ensure the health and well-being of all participants. This section gathers information on food preferences and dietary needs.

1. Do you have any dietary restrictions or food allergies that we should be aware of (e.g., vegetarian, vegan, gluten-free, dairy-free, nut-free)?
   • Yes
   • No
   • If yes, please specify: ___________________________________________________________
2. Do you have any other food preferences or specific meal requirements (e.g., halal, kosher, low-sodium, low-carb, etc.)?
   • Yes
   • No
   • If yes, please specify: ___________________________________________________________

5. Medical Emergency Contact

In the event of a medical emergency during the retreat, it is essential to have a designated person to contact. Please provide the details below.

1. Emergency Contact Name:
   • Full Name: ___________________________
2. Emergency Contact Phone Number:
   • Phone Number: ___________________________
3. Relationship to Participant:
   • Family Member
   • Friend
   • Other (Please specify): ________________

6. Acknowledgment of Risk and Waiver of Liability

By signing below, you acknowledge and agree to the following:

1. Acknowledgment of Health Status: I understand that the retreat includes physical activities that may involve exertion and stress. I affirm that I have disclosed all relevant health information and that I am physically able to participate in the activities for which I have signed up. I understand that failure to disclose health conditions may result in injury or harm, and I take full responsibility for any adverse health effects related to my participation.
2. Waiver of Liability: I acknowledge that participation in the SayPro Monthly Wellness Retreat involves inherent risks, including physical injury, and I assume full responsibility for my participation in all activities. I release SayPro, its employees, contractors, and agents from any and all liability for any injury, accident, illness, or damage that may occur during my participation in the retreat.
3. Emergency Medical Authorization: In the event that I am unable to communicate due to illness or injury, I authorize SayPro to seek medical treatment on my behalf. I understand that SayPro will make reasonable efforts to contact my emergency contact in such cases.
4. Voluntary Participation: I understand that my participation in the retreat is voluntary and that I may choose to refrain from any activities or workshops at any time, without penalty, should I feel that the activity is beyond my physical capacity or could cause harm.
5. Consent for Photography/Recording: I consent to the use of my image, voice, and likeness for promotional purposes by SayPro, including but not limited to photos, videos, or testimonials taken during the retreat.
   • I Agree
   • I Do Not Agree

7. Participant’s Signature

By signing below, I confirm that I have read and understood the contents of this Medical and Health Waiver. I acknowledge the inherent risks involved in participating in the SayPro Monthly Wellness Retreat and agree to comply with all safety guidelines and instructions provided by the retreat organizers.

Participant’s Signature: ___________________________
Date: ___________________________

8. Parent/Guardian Signature (if applicable)

If the participant is under the legal age of consent, a parent/guardian signature is required.

Parent/Guardian Name: ___________________________
Parent/Guardian Signature: ___________________________
Date: ___________________________

Conclusion

The SayPro Medical and Health Waiver ensures that all participants in the January SCDR-4 Wellness Retreat are fully aware of any potential risks related to the physical, dietary, or health-related aspects of the retreat. By disclosing health information and acknowledging the inherent risks, employees can participate in the retreat with a clear understanding of their safety needs, while organizers can provide the appropriate accommodations and support for a safe and enjoyable retreat experience.