Vipassana Hawaii

WAIVER OF LIABILITY AND AUTHORIZATION FOR MEDICAL TREATMENT

I voluntarily agree to participate in retreat activities sponsored by Vipassana Hawaii (VH). I have read the information describing the retreat I am attending. I realize that all activities at VH retreats are voluntary and entirely at my discretion. These may include a daily work period of about 1 hour. If I have any concern about my ability to safely complete an assignment, I will notify a staff member immediately. I also realize that there are unanticipated risks during such activities. I hereby assume all risks of injury to me and my property that may be sustained in connection with activities undertaken while at a VH retreat.

I agree that in the event of a medical or psychological emergency, VH has the authority and sole discretion to contact 911 emergency services, as well as the designated emergency contact person that I have named on the retreat questionnaire. I understand that VH sponsors meditation retreats and is not expected to provide medical and/or psychological care.

Any costs incurred for health and emergency services are my responsibility and not the responsibility of VH or the Zen Center. I understand that VH will make every effort to communicate with my designated contact person/s in an emergency.

I further understand that participation in VH retreats is at the discretion of the teachers and VH administration at all times. If, in the opinion of VH, I am unable to continue to participate productively in the retreat, I may be asked to leave.

I have read this agreement and fully understand its contents. I agree to it of my own free will. I am of full age and accept the above disclaimer and authorization.

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