• STATEMENT OF PSYCHOLOGICAL AND HEALTH CONDITION

    All information provided on this form is kept confidential.

    Wholelistic Wellbeing, LLC
    7827 N. Armenia Ave, Tampa, FL
    813-789-8377
    wholelisticwellbeing@gmail.com
    www.wholelisticwellbeing.com
  • Please Initial after each item and then sign below:

  • WOMENS HEALING / WELLNESS MEDIA RELEASE FORM

    Vitality Women's Healing Retreat, USA

    Elohee Retreat Center - 770-316-9195
    Thanksgiving House

    Date: June 26 - 26, 2022
    Trip leader: Donna Sharpe
    Trip Webpage: www.wholelisticwellbeing.com
  • AUTHORIZATION AND RELEASE FOR USE OF PHOTOGRAPHIC IMAGES AND VIDEOS

  • I hereby grant Wholelistic Wellbeing, LLC and its agents, officials, representatives, or assigned agencies, including officers, employees, or related personnel both individually and collectively (the “Released Party”) the absolute and irrevocable right and unrestricted permission in respect of photographic portraits, videos or pictures that the Released Party had taken of me (the “Photographic Images”), whether individually or together with one another and/or other individuals and the content of any verbal or written statements made by me and used in connection with such Photographic Images, in the name of the Released Party or otherwise.

    I further grant to Wholelistic Wellbeing, LLC the absolute and irrevocable right to use, re-use, publish and re-publish the Photographic Images in whole or in part, individually or in conjunction with other photographic images, and in art, editorials, advertising and trade, or any other purpose whatsoever including, without limitation, the promotion of any websites or brands owned or operated by the Released Party without restriction as to alteration; by any medium or channel including but not limited to television, radio, newspaper or other periodical, Internet, or any other means whether electronic or otherwise; and to use my name, location, profession, and/or any other identifying or potentially identifying information in connection therewith if the Released Party so chooses.

    I hereby release and discharge the Released Party from any and all claims and demands arising out of or in connection with the use of the Photographic Images, including without limitation any and all claims for libel, invasion of privacy, or false light, and from any and all liability for damages of whatever kind, which may, at any time, result to me, my heirs, legal representatives, and assigns because of compliance with this Authorization and Release.

    This Authorization and Release shall also inure to the benefit of the heirs, legal representatives, licensees, and assigns of the Photographer, as well as the persons for whom s/he took the Photographic Images.

    I have read the foregoing and fully understand the contents thereof. This Authorization and Release shall be binding upon me, my heirs, legal representatives, and assigns.

  • MM slash DD slash YYYY

Vitality Food Healing / Wellness Retreat, USA

Elohee Retreat Center - 770316-9195
Thanksgiving House
Date: June 23-26,2022
Trip leader: Donna Sharpe
Trip Webpage: www.wholelisticwellbeing.com

WELCOME GUEST,

Thank you for joining us on this beautiful retreat in the GA Mountains! We are excited you could join us for this heartfelt adventure. To make sure you have a great trip, we have enclosed some helpful information.

BEFORE THE TRIP!

Please Complete and submit your

Please complete your application at www.wholelisticwellbeing.com - retreat page] as soon as possible. please feel free to contact us if you have any question or concerns while completing this aaplication.

The Trip costs are: $2695.00 with a $600 paid non refundable deposit to reserve your space. The first five guest will receive a $200 discount off the total amount of the retreat.

Credit card payments are accepted with a 3% fee of each paid amount.

if your are inviting a friend please be sure they read and complete all desired forms of their own and in its entirety and include the referral partner to this event.Please list your desired room partners for the weekend (Please keep in mind this is a small quaint event and your may be roomed with a new guest who have not met).

if cancellation occurs 60 or more before departure there will be no loss of deposit. Any cancellation made between 30-60 days will result in a total loss of your $600 USD deposit. Any cancellation between 30days and the trip departure will result in a total loss of funds. We reserve the right to cancel the trip if it is not meeting the trip minimum (if we do so your deposit is refunded). Trip cancellation insurance is always recommended when making travel plans.

All forms must be signed and received in the office before departure or you will not be able to travel with us.please understand our insurance carrier requires this of us! Also, it is essential that you put your flight information on the trip application form so we know when your flight is arriving! if your form of transport is by wehicle please let us know your exact arrival time.
Donna has captivated many individuals over the years as a Speaker | Inner Healing Coach | Facilitator. Her healing gifts and lessons of how to live a holistic life of vitality have been positively received and implemented by many clients over the years.
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