Paradise Wellness Luxury Getaway Registration           www.paradisewellnesspr.com
WELCOME TO PUERTO RICO!

We are so excited that you have taken the time to take care of you.  Getting away from the pressures of life is so vital to recharge.  We are honored that you have chosen us for your Wellness Vacay to and enjoy and learn about the abundance of living a healthy abundant lifestyle.  We find that the world is moving so fast around us and incorporating healthy foods into your vacation makes it a super fantastic experience!

All we ask is that you go with the flow, ask lots of questions, be honest with your body, and listen to Nature!  Eat to Love!!



Peace  
Skai Juice
www.paradisewellnesspr.com

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Name *
Address *
Cell *
Email *
Date of Birth *
Occupation *
What dates are you interested in arriving here? *
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What dates are you interested in departing? *
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Who is the friend you are bringing? *
for rooming purposes
Your Diet Information *
Breakfast, Lunch, Dinner, Snacks. Please describe your typical diet and give us an idea of what you eat. Include beverages. Vegetarian, Meat Eater, Flexitarian, etc.
Are you currently taking any prescription drugs/medications? Over the counter meds? Recreational drugs? *
If Yes, please list
What are your side effects, if any?
Any other health concerns we should know about? *
Check all the items that you consume on a regular basis *
This information helps with concerns on your detoxing.
Required
What are you hoping to achieve? *
What is your goal while you are here?
What is your swimming ability? *
 Emergency Contact Info *
Please note that Paradise Wellness is an island rejuvenation retreat; we are NOT a clinic or medical facility. We do not offer medical advice or intervention and we have no medical doctors on site; however we can make arrangements for you to visit a local physician or emergency medical facility if you find it necessary. If you currently have a medical condition, please consult your physician to determine if our programs are appropriate for you.  You will be required to sign a disclaimer releasing Paradise Wellness from any responsibility for any health conditions you experience, pre-existing or otherwise. Please list two contacts, their phone and email address, and their relationship to you.
PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK *
In consideration of the services of Paradise Wellness, its agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on its behalf, I hereby agree to release, indemnify, and discharge Paradise Wellness, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows: I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of any risks. I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Paradise Wellness from any and all claims, demands, or causes of action, which are in any way connected with my participation in this activity or my use of the equipment or facilities of Paradise Wellness, including any such claims which allege negligent acts or omissions on the behalf of Paradise Wellness. Should Paradise Wellness, or anyone acting on its behalf, be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold it harmless for all such fees and costs. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. In the event that I file a lawsuit against Paradise Wellness, I agree to do so solely in the commonwealth of Puerto Rico, and I further agree that the substantive law of Puerto Rico shall apply in that action without regard to the conflict of law rules of that commonwealth. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect. I agree that any action against Paradise Wellness will be resolved in the exclusive jurisdiction of the superior court of San Juan.  By signing this document I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Paradise Wellness on the basis of any claim from which I have released them herein. I have had sufficient opportunity to read this entire document. I have read and understand it, and I agree to be bound by its terms. Please Submit your name and address as your signature to this agreement.
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