By checking the box and entering my name in the field below, I confirm that I have read and understood all the medical information provided above and that I have openly disclosed all required health and medical facts. I also confirm that I am of sound mind and agree to the rules of the Amayas retreat. I certify that the above information is true and complete to the best of my knowledge. I acknowledge that falsifying or omitting any relevant information may be grounds for denying me participation in a retreat I am applying for with or without a refund at Amayas' sole discretionI hereby declare that I acknowledge that under no circumstances and for any reason can Amayas be held responsible for any injuries or damages that may occur during the retreat. I acknowledge that Amays is not a medical facility and its owners, employees and agents do not practice Western medicine and are not licensed physicians.