Overnight Retreat Agreement

Welcome!  I am excited that you are able to join us for the Rising Mastermind Retreat! I request that you participate in only those activities that you are physically, mentally, emotionally, and spiritually able to do, and that you notify me of any restrictions you have regarding any of the activities, and I will do our best to accommodate them. Your safety and comfort is of the utmost importance to me.

Please read the following information carefully and let me know if you have any questions before signing and returning it to me.

This Agreement is being made between Jillian Bolanz, LLC. 6 Maple Street, Cumberland, Maine, 04021. (“Retreat Facilitator” or “me”) and Attendee’s name, address, city, state, zip (“Attendee” or “you”).  We both legally agree to the following:

  1. Retreat Description.

The Rising Mastermind Retreat (“Retreat”) will include a 2-day overnight event from March 29, 2019 until March 31, 2019 at Point Lookout (“Hotel”) in Northport, Maine United States of America.


Your Retreat will include a variety of activities to support the work we will be doing together, possibly including but not limited to women’s circles, physical activities including but not limited to hiking, dancing, stretching, dining together, journaling, connecting, coaching, meditating, applying essential oils, driving, and walking. (“Program Activities”). Breakfast/lunch/dinner/snacks will be provided for you each day. Please add a note to inform us if there are any allergies or aversions. Also, feel free to bring food that best supports you if you feel so inclined.

You will be enrolled in the Retreat upon the receipt of: (1) this signed Agreement and (2) payment in full of $297.00.

  1. Expectations and Responsibilities.

As your Retreat Facilitator, my role is:

    • To come to each day of the Retreat fully present, prepared and ready to facilitate our work together.
    • To serve as your Retreat Facilitator, accountability partner, cheerleader and supporter when it comes to your commitment to yourself.
    • To be respectful of the time we have together and the value of this work.
    • To provide support and guidance designed to move you forward on your journey.
    • To offer encouragement, feedback and tips throughout the Retreat.

As the Attendee, it is your role and responsibility:

  • To be fully present at the Retreat, which means no use of cell phones or e-mail during Retreat sessions, and not arriving late or leaving early from Program Activities or the Retreat, if at all possible.
  • To fully show up physically, mentally and emotionally as you are to each and every day and session of the Retreat, no matter what life or schedule distractions arise or resistances you may encounter.
  • To commit to the Retreat and come with an open mind.
  • To give yourself ample buffer space to transition into and out of our time and experience together.
  • To complete your pre-work and homework before the Retreat.
  • To stay curious about yourself, your behavior and everything that is shared or suggested by the Retreat Facilitator or other attendees.
  • To add to and receive from the experience of others who are with you at the Retreat.
  • To participate in the Retreat with the expectation that you have the power to change.
  • To act with respect towards every other person at the Retreat, whether other attendees, the Retreat Facilitator, other team members, Hotel staff, or anyone else you encounter.
  • To promptly provide payment for the Retreat.
  • To ask any questions you may have as they arise.
  • To have fun!

       3. Scheduling, Travel and Hotel Accommodations.

Jillian Bolanz, LLC has booked all cabins and will be assigning rooms. You are responsible for booking your own travel, including air and/or ground transportation. You are also responsible for following all Hotel and Retreat policies including the following:

  • You, as a Hotel guest, are subject to all regular Hotel policies, including noise, number of people per room, etc. so it is your responsibility to become familiar with the Hotel expectations and policies upon check in.
  • The Retreat Facilitator is not responsible for pairing you with a roommate. If you do choose to have a roommate, if your roommate experience is not satisfactory, you, and not the Retreat Facilitator, are responsible for making alternative arrangements at your own expense.

       4. Investment and Payment.

Investment:  You agree that you are financially willing and able to invest in this Retreat by choice, and by so doing, you are not in any way incurring any economic hardship.


Payment in Full.

  • If you are paying in full, your full investment of $297.00 must be made at the time you enroll in the Retreat.

Authorization and Receipt:  If paying by debit card, credit card, or PayPal, you give us permission to automatically charge your credit or debit card as payment for your Retreat without any additional authorization, for which you will receive an electronic receipt. Once the billing dates are agreed upon, you are responsible for being aware of your billing dates, so if there are any changes that need to be made to your billing information in order for your payment to be processed, you are responsible for letting me know in advance by sending an e-mail to me.


Missed Payment:  In the event that payment is not received by the date due or there is a problem with the payment transaction or method, you will be notified by e-mail and then have a 3-day grace period to make the payment following the due date, whether paying in full or by installment. We reserve the right to seek payment through a collection agency if needed. Money is a symbol of commitment and I encourage you to make a commitment to yourself to promptly provide payment for this Retreat when payment is due.


Cancellation & Refund Policy:   If you decide to cancel your enrollment in or attendance prior to the Retreat, the following Refund Policy applies:


  • If you cancel 61-179 days prior to the Retreat, you may request a refund of 30% of your payment made to date by sending an e-mail to me and stating the reason for the cancellation.


  • If you cancel 30-60 days prior to the Retreat, you may request a refund of 20% of your payment made to date by sending an e-mail to me and stating the reason for the cancellation.


  • If you cancel 0-29 days prior to the Retreat, no refunds will be provided for any reason.


     5. Intellectual Property Rights.

The Retreat Facilitator retains all ownership rights to the materials provided to you through your participation in the Retreat.  Any copyrighted and original materials shall be provided to you for your individual use only and with a single-user license. You are not authorized to share, copy, distribute, or otherwise disseminate any materials received at or in relation to the Retreat electronically or otherwise without the Retreat Facilitator’s prior written consent. All intellectual property, including the copyrighted Retreat materials, shall remain the Retreat Facilitator’s sole property and no license to sell or distribute any materials is granted or implied. You agree not to reproduce, duplicate, copy, sell, trade, resell or exploit for any commercial or personal purposes, any portion of the Retreat content, including any of the Retreat materials.


      6. Media Release.

By participating in the Retreat, you consent to photographs, videos, and/or audio recordings that may be made that may contain you, your name, identity, voice and/or likeness. In the Retreat Facilitator’s sole discretion, we reserve the right to use these photographs, videos, and or/audio recordings and/or any other materials submitted by you in connection with your participation in the Retreat (“Media”) in our current or future retreats, programs, products or services, and/or our marketing or promotional efforts, without any additional permission or compensation to you at any time, now or at any time in the future. You also agree that you give the Retreat Facilitator the full right to edit, give, transfer, and exhibit the Media however the Retreat Facilitator sees fit. You agree to waive the right to inspect or approve any edited, unfinished, or finished Media, and you hereby hold harmless, release and forever discharge the Retreat Facilitator from all claims, demands, and causes of action which you, your heirs, representatives, executors, administrators, or any other person acting on your behalf have, may have, or could have now or in the future by reason of this authorization, including any reasonable expectations of privacy or confidentiality with respect to the Media.

     7. Consent, Release, Waiver, and Disclaimer.

By enrolling in the Retreat, you hereby agree to the following:

              1. You voluntarily desire to participate in the Retreat and you take full and sole responsibility for your life and well-being and all decisions made before, during and after the Retreat.
              2. You acknowledge that you are choosing to participate voluntarily in Program Activities at the Retreat and you recognize that these Program Activities may contain certain inherent risks. You represent that you are in good health and you understand that you may decline from participating in any of the Program Activities if you deem it to be in your own best interest. You voluntarily and expressly assume the risks of the Retreat and all Program Activities.
              3. You understand that you are responsible for reading all information provided by the Retreat Facilitator before and during the Retreat, including any and all Agreements, schedules, policies, procedures and notices related to the Retreat, including travel and Program Activities.
              4. You agree to observe and obey all posted and announced rules and warnings, and further agree to follow any instructions or directions given or provided by the Retreat Facilitator, the Hotel or either of their representatives or agents.
              5. You understand that the information provided at or in conjunction with the Program Activities and Retreat is not intended to be a substitute for professional medical advice, diagnosis or treatment that can be provided by your own physician, therapist, licensed dietitian or nutritionist, or any other licensed or registered mental or physical health care professional. You understand that the Retreat Facilitator is not acting in any capacity as a medical or mental health care provider. You understand that the Retreat Facilitator is not providing health care, medical or nutrition therapy services or attempting to diagnose, treat or cure in any manner whatsoever any disease, condition or other physical or mental ailment of the human body during the course of the Retreat. Rather, the Retreat Facilitator is serving in her capacity as a Retreat Facilitator, guide, educator, and mentor.
              6. You understand that you may be provided with food and possibly other products while at the Retreat and you agree to disclose to the Retreat Facilitator in advance any known or suspected allergies or food sensitivities at least 30 days prior to the Retreat by sending an e-mail to the Retreat Facilitator. You understand the Retreat Facilitator does not and will not have any responsibility or control over food preparation or contamination; therefore, you agree that the Retreat Facilitator is not liable for any act, default or omission of the Hotel, Hotel staff, or any outside supplier related to the food or products provided at the Retreat.
              7. You also agree to disclose in advance any physical limitations that may impact your breathing or movement, skin reactions or issues, or any other health or mental condition that may be affected during the Retreat. If you suspect that you have a medical or mental health problem, you agree to inform the Retreat Facilitator, the Hotel and/or their agents immediately.
              8. You agree to seek the advice of your physician or another qualified health care professional prior to and during the Retreat regarding any questions or concerns you have about your specific health situation, possible or actual pregnancy, known or suspected food or other allergies or sensitivities, dietary restrictions, or any medications you are currently taking.  You understand that you are advised to speak with your own physician or mental health provider before attending the Retreat or implementing any Program Activities. You agree to not disregard or delay seeking professional medical advice or stop taking any medications without speaking to your own physician or mental health care professional.
              9. At any time before or during the Retreat, should you know or feel that you may cause imminent harm to yourself, other participants, the Retreat Facilitator, or any other person, you understand and agree that you are immediately obligated to let the Retreat Facilitator know, and to remove yourself from the situation in a peaceful and cooperative manner; otherwise, you consent that you may be asked to not attend the Retreat, leave the Retreat, and/or have immediate physical or mental health care administered to avoid causing mental or physical harm to yourself or others. You agree that the Retreat Facilitator reserves the right to decline accepting or retaining you if your physical or mental health or actions in the Retreat Facilitator’s sole judgment might impede the Program Activities or Retreat or the welfare or enjoyment of the experience by the Retreat Facilitator, her agents, Hotel staff, or other attendees.
              10. You consent to the application of first-aid or other medical or mental health services to be applied if needed in connection with an emergency health problem or potentially harmful situation during the Retreat, and you agree to hold the Retreat Facilitator harmless as a result of any such injury or damage you may suffer due to the application of medical or mental health services or treatment. You fully understand that first-aid or other medical or mental health services may not be readily available based on circumstances outside of the Retreat Facilitator’s control.
              11. You also agree and consent that the Retreat Facilitator or her agents may contact your Emergency Contact as shown on the bottom of this form for any physical or mental health reason and may disclose the circumstances surrounding that reason, if they deem it necessary, without liability and based on her sole discretion.
              12. You acknowledge that you are solely and personally responsible for your choices, actions and results, now and in the future. You accept full responsibility for the consequences of your use or non-use, of any information provided before, during or after the Retreat, and you agree to use your own judgment and due diligence before implementing any idea, suggestion or recommendation from the Program Activities and Retreat to your life, family or business. You fully agree that there are no guarantees as to the specific outcome or results that you can expect from using the information you receive on or through the Program Activities and Retreat, including no guarantees that you will have any other specific result.
              13. As with all situations, you understand that there are sometimes unknown individual risks and circumstances that can arise during the Program Activities or Retreat that cannot be foreseen or controlled by the Retreat Facilitator. You understand that attending and/or participating in the Program Activities and Retreat is to be taken fully at your own risk, recognizing that there is a rare chance that illness, injury or even death could result.
              14. You understand and agree that the Retreat Facilitator is not responsible for travel reservations, airfare, fees, taxes, tips, passports, visas, customs documents of entry, immunizations, or any other necessary or recommended paperwork or procedures that are required by the laws, regulations, orders and/or requirements prior to or during inside or travel outside of the United States. You understand that you are responsible for booking travel (which is recommended at least 30 days in advance), including flight, Hotel accommodations, and ground transportation to and from the Retreat. You are also responsible for bringing proper identification, which may include a valid passport, visa or other paperwork, that is valid for the requisite amount of time pre-travel and post-travel as required by the laws of your home country and the laws of the country where the Retreat is being held. You understand that you are responsible for obtaining the appropriate medical and trip/flight cancellation insurance and for knowing its applicability in the location where the Retreat is being held, if such insurance is so desired.


     8. Limitation of Liability, Indemnification & Release of Claims.

    1. By attending and/or participating in the Program Activities and Retreat, you agree to absolve the Retreat Facilitator of any damage, liability or loss that you, or any other person, may incur from use of the information, products or materials that you receive before, during or after the Retreat and Program Activities. You agree that the Retreat Facilitator will not be liable to you, your family, dependents or heirs, or to any other individual, company or entity, for any type of damages, including direct, indirect, special, incidental, equitable or consequential loss or damages, for your participation in or reliance on the Program Activities or Retreat, or for your own personal emergencies, legal situations, theft or loss of belongings or luggage, or any food, travel, or use of the Hotel premises during or outside of the provided Program Activities or Retreat, at any time now or in the future, with the exception of gross negligence by the Retreat Facilitator or Hotel or otherwise provided by law.You agree that the Retreat Facilitator does not assume liability for accidents, delays, injuries, harm, loss, damage, death, lost profits, personal or business interruptions, misapplication of information, physical or mental diseases, allergies, sensitivities, conditions or issues, or any other type of loss or damage due to any act, default or omission by the Retreat Facilitator, Hotel, or anyone acting as the Retreat Facilitator’s or Hotel’s agent, consultant, affiliate, joint venture partner, employee, shareholder, director, staff, team member, or anyone otherwise affiliated with the Retreat Facilitator’s businesses or who is engaged in delivering programs, products, or services during or related to the Program Activities and/or Retreat.You agree now that you fully and completely hold harmless, indemnify and release the Retreat Facilitator and any of the Retreat Facilitator’s agents, consultants, affiliates, joint venture partners, employees, shareholders, directors, staff, team members, or anyone otherwise affiliated with the Retreat Facilitator’s businesses from any and all causes of action, allegations, suits, claims, damages, or demands whatsoever, in law or equity, that were to arise in the past, present or future by you, your family or heirs, your business or company, or any other third party or entity for any action, default or omission in any way related to the Program Activities and Retreat.In no event will the Retreat Facilitator be liable to you or to any party for any direct, indirect, special, incidental or consequential damages for any use of, non-use, or reliance on this Retreat, the Program Activities, or its information, programs and/or services, including, without limitation, personal injuries, accidents, misapplication of information, or any other loss, malady, disease or difficulty, or otherwise, even if you are expressly advised of the possibility of such damages or difficulties, whether caused by the fault of you, the Retreat Facilitator, other attendees, other third parties, a force majeure, or any other act or circumstance outside of the control of the Retreat Facilitator. 

      You agree to act in a manner that is respectful and considerate of the Retreat Facilitator, all other Retreat attendees, the Hotel staff, other third parties, and the facilities, and you agree to follow all laws, regulations and ordinances. You agree to pay for all damages to others and/or the facilities caused by any negligent, reckless, or willful action that you may take.

     9.Other Important Terms.

    1. Notice:  All correspondence or notice required regarding the Retreat or this Agreement shall be made to me at jillian@jillianbolanz.com and to you at the e-mail address in the signature block below. Should your e-mail address or contact information change at any time throughout the course of the Program, it is your responsibility to provide your new contact information to me within 72 hours of any such change.Entire Agreement, Assignment, Survivability and Waiver: This Agreement contains our entire agreement. This Agreement may be modified or amended at any time if the amendment is made in writing and is signed by both of us. You may not assign your rights or obligations under this Agreement to anyone else. The failure to enforce any provision of this Agreement shall not be construed as a waiver or limitation of the right to later enforce and compel strict compliance with every part of this Agreement.  In the event that any part of this Agreement is deemed invalid or unenforceable, it shall not affect the validity or enforceability of any of the remaining portions of the Agreement which shall be severed and remain in full force.Governing Law:  This Agreement shall be construed according to the laws of the State of Maine and all laws and regulations of Cumberland County where my business is based.Dispute Resolution:  It is hoped that should we ever have any differences, we could be able to work them out through a phone conversation or e-mail correspondence. However, should a dispute ever arise between us, we agree now that we will submit to binding arbitration before a single arbitrator, selected jointly, in accordance with the American Arbitration Association Rules. Prior to seeking arbitration, you must submit your complaint to me with full details about your dissatisfaction via e-mail to me at my e-mail address below. You understand and agree now that the only remedy that can be awarded to you through arbitration is full refund of your payment made to date. No award of consequential or of any other type of damages may be granted to you. Any judgment on an arbitrator’s award, if made, is binding and may be entered into any court having the appropriate jurisdiction. By signing this Agreement you are agreeing to a modification of the statute of limitations such that any arbitration must be commenced within one (1) year of the date of the act, omission, or other conduct complained of as submitted by you in e-mail, or shall otherwise be forfeited forever. You also agree that should arbitration take place, it will be held in Cumberland County in the State of Maine where my business is located and the prevailing party shall be entitled to all reasonable attorney’s fees and costs necessary to enforce the Agreement.


      Non-Disparagement:  In the event of a dispute between us, you agree to not engage in any conduct or communications, public or private, including social media, designed to disparage the Program or me, including the Overnight Retreat and my business. Where requested by law or arbitration, of course, you are not prohibited from sharing your thoughts and opinions as a part of the legal process.


      By signing this Agreement, we are both acknowledging that we have read, understand, agree to and accept all of the terms in this Agreement. You understand that by signing this Agreement, you knowingly and voluntarily surrender certain legal rights.



      Name: ____________________________________________________


      Address: __________________________________________________


      City, State, Zip: _____________________________________________

      E-mail Address: _____________________________________________

      Date: _____________________________________________________

      Retreat Facilitator 


      Name:    __Jillian Bolanz________________________________________


      Title: ___Intuitive Life Coach___________________________________

      Business Name:_Jillian Bolanz, LLC______________________________


      E-mail Address: __jillian@jillianbolanz.com_________________________


      Date: _____________________________________________________


      Emergency Contact Information:
      In case of an emergency, you authorize the Retreat Facilitator and her agents to contact the following Emergency Contact by phone, text, and/or e-mail and convey pertinent details related to the situation:


      Relationship to You:_____________________________________________________

      Cell Phone: ____________________________________________________________

      E-mail: ________________________________________________________________