Page 1 of 2




Your Contact Information














In-Person Event Details







I hereby affirm that I have been well advised of the inherent risks associated with participating in an Natura Institute of Ecology (Natura) program at the Commonweal Garden that you will be visiting. I understand those risks include, but are not limited to the risk of exposure to potentially poisonous plants, uneven and/or slippery walking surfaces, woodland fires, rattle snakes and other risks which may result in property damage, personal injury or even death. I understand that injuries can occur even if Commonweal, Natura Institute of Ecology and Medicine and others have taken all reasonable precautions. I further understand that due to the locations visited, medical treatment for such injuries could be delayed. Nonetheless, I choose to participate in the activities of the Natura program.
 
I HEREBY PERSONALLY ASSUME ALL RISKS WHICH MAY OCCUR DURING THE NATURA PROGRAM, FOR ANY HARM, INJURY, ILLNESS, DEATH OR DAMAGE THAT MAY BEFALL ME WHILE PARTICIPATING IN ITS ACTIVITIES, WHETHER FORESEEN OR UNFORESEEN. I WISH TO PARTICIPATE IN NATURA PROGRAM IN SPITE OF THOSE RISKS AND THE POSSIBLE DELAY IN MEDICAL ASSISTANCE. 

I AGREE THAT I WILL ASSUME ALL RESPONSIBILITY FOR ANY INJURY, ILLNESS AND/OR DAMAGE AND RELATED COSTS, MEDICAL EXPENSES AND DAMAGES OF ANY KIND THAT I MAY INCUR ARISING OUT OF OR RELATED TO PARTICIPATING IN THE NATURA PROGRAM ACTIVITIES AT THE COMMONWEAL GARDEN. 

I FURTHER AGREE THAT I HOLD COMMONWEAL, NATURA INSTITUTE OF ECOLOGY AND MEDICINE, THE OFFICERS, AGENTS, MANGERS, CONTRACTORS, EMPLOYEES, AND VOLUNTEERS FREE OF ANY AND ALL CLAIMS FOR LIABILITY, INJURY, ILLNESS, DEATH, COSTS, MEDICAL BILLS OR OTHER DAMAGES INCURRED BY ME OR MY FAMILIY, HEIRS OR ASSIGNS, NO MATTER HOW CAUSED, INCLUDING DAMAGES, INJURIES, ILLNESS OR DEATH ALLEGED TO BE PARTIALLY OR SOLELY CAUSED BY COMMONWEAL AND NATURA INSTITUTE OF ECOLOGY AND MEDICINE’S OMISSIONS, COMMISSIONS, CARELESSNESS, NEGLEGENCE OR LIABILTY WITHOUT FAULT. 

I EXPRESSLY DO NOT GIVE UP THE RIGHTS AND REMEDIES THAT MAY BE AVAILABLE TO ME UNDER CALIFORNIA LAW WHICH MAY ARISE DUE TO COMMONWEAL AND NATURA INSTITUTE OF ECOLOGY AND MEDICINE'S GROSS NEGLIGENCE AND/OR WILLFULL MISCONDUCT. 

I understand that the WAIVER AND RELEASE OF LIABILITY applies whether or not such injury, damage or loss is in any way connected with participation in any activities offered by Commonweal, Natura Institute of Ecology and Medicine and whether such injuries result from my own negligent acts or from the acts of other participants. I also understand these terms are contractual and not a mere recital. I have signed this document of my own free will. 

In the event I am medically unable to give permission (for clients 18 and older) or in the event I cannot be reached in an emergency (parent/guardian of client under the age of 18), I give permission to the medical personnel designated to conduct x-ray examinations, hospitalize, or order any treatment deemed necessary, including anesthesia, injections, surgery, and or other care (for my child).   
I further agree that in the event of any dispute whatsoever between me and Commonweal and Natura Institute of Ecology and Medicine concerning my participation in any of its activities, I will first submit the matter to non-binding mediation before the American Arbitration Association (AAA) Center for Mediation in San Francisco, California. In addition, should Commonweal, Natura Institute of Ecology and Medicine and I fail to resolve our differences through mediation, I will submit any remaining dispute or claim to binding and final arbitration before the AAA in San Francisco, California. 

I further agree that this WAIVER AND RELEASE OF LIABILITY is effective for my participation in the Natura Program and activities for three years following the date that I sign it. 
I have read this form carefully and completely before checking the box below, and I understand and agree to all of its terms.

Page 2

Payment Information
Tier 1 represents the actual cost of this event. We offer a sliding scale of price tiers to increase access to all. If you would like to attend but the cost is still prohibitive, please contact us: info@naturainstitute.org





Please enter the discount code exactly as it was provided to you. The code is case-sensitive and does not contain spaces.
additional full registrations.
Support Natura Institute
Cancellation Policy
It is important to consider that enrolling in this program is a commitment to yourself, to each participant and to the group as a whole. The cancellation policy is designed to support you in consciously agreeing to what you are saying “yes” to and to having all aspects of the program run smoothly and powerfully. 

• If notice of cancellation is received at least 30 days before the start of the program, all payments will be refunded except for the non-refundable deposit. 
• If notice of cancellation is received within 30 days before of the start of the program or once the program has commenced, all payment is forfeited. 
• Please note, credit card processing fees will only be refunded if Commonweal cancels the program or changes the date / time / location.  Credit card processing fees will not be refunded when a customer requests a refund for personal reasons


IF NATURA CANCELS: It is highly unlikely that we will cancel the program due to unforeseen circumstances or low enrollment. Please note that if we need to cancel the program for any reason, participants will be notified at least two-weeks before the start of the program. You will receive a full refund for the total amount paid up until that point. Note that you may want to wait to buy any plane tickets until we let you know that the program is confirmed. 


AGREEMENT: I understand the cancellation and refund policy and I understand that I will be held personally liable for any amount of my tuition that is not paid in full within the aforementioned period of time.


Payment

Pay by Check
Please include the event name in the memo and mail your check to:

Natura Registration
c/o Commonweal
P.O. Box 316
Bolinas, CA  94924
Credit Card Payment Information