Massoga® Retreat Guest Info Form
Retreat Location

digital free

Would you like to go digital free for the weekend?

*Your devices will be locked away in the retreat office. You are welcome to access your phone for 30mins a day to check in with loved ones.

Health History

List any known food allergies

Musculoskeletal
Nervous System
Respiratory
Circulatory
Reproductive
Skin
Digestive
Psychological
Others

Please explain any of the conditions that you have marked above:

Any other medical condition(s) not listed:

Is there anything else you wish to share with us?

client agreement

It is my choice to receive massage therapy. I am aware of the benefits and risks of massage and give my consent for massage. I understand that there is no implied or stated guarantee of success of effectiveness of individual techniques or series of appointments. I acknowledge that massage therapy is not a substitute for medical care, medical examination or diagnosis. I have stated all medical conditions that I am aware of and will inform my practitioner of any changes in my health status. 

terms & conditions
By purchasing this retreat with Massoga® Massage Yoga I agree its owners, teachers and any person employed by Massoga® Massage Yoga are in no way responsible for the safekeeping of my personal belongings. I understand that classes may be physically strenuous, I will be adjusted and massaged, and I voluntarily participate in this with full knowledge that there is risk of personal injury, property loss or death. I agree that neither I, my heirs, assigns or legal representatives will sue or make any other claims of any kind whatsoever against Massoga
® Massage Yoga or its members for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise.

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