Full Name (Primary Guest)

Names of additional guest (if any)

Preferred pronouns (optional)

Your Email

Subject

Tell us a bit about yourself

Upload Photo ID (for identity verification)

Consent

I agree to provide government-issued photo ID to verify my identity for safety and security purposes. All IDs will be stored securely and permanently deleted after the retreat.

Social Media Handles

Your Cellphone #

Do you have any dietary restrictions?

Where are you traveling from?

What are you hoping to learn from WhichBetty during your experience?

Which offerings are you most interested in? (Check all that apply)

ForagingShinrin-yoku (forest bathing)Content-creation support or mentorshipCreative collaborationBooking a tattoo session (additional cost)Time to rest or writeOther

If you selected “Other”, please specify:

Do you have any experience with foraging or spending time in nature?

YesNoA little — tell me more below

If you answered “A little,” feel free to share more:

Logistics & Respect

Sorry, no pets allowed.

Do you have any allergies, accessibility needs, or sensitivities?

Are you comfortable with a quiet, tech-light, eco-friendly stay?

YesNoI have some questions

If you selected “I have some questions”, please share here:

Fitness & Activity Level

How would you describe your general fitness level and ability to participate in foraging walks or shinrin-yoku?

(Please note any limitations or concerns.)

Smoking Policy

This property is non-smoking inside. Outdoor smoking is permitted only in the designated area, with proper disposal of butts.

Are you comfortable with this policy?

YesNo

Anything else I should know about you or your guests?

Have you ever been charged with or convicted of a violent crime?

YesNo

Waiver, Risk & Conduct Agreement

1.   Assumption of Risk

I fully understand that participation in forest excursions, foraging walks, shinrin‑yoku (forest bathing), and related outdoor activities (“Activities”) involves inherent risks, including but not limited to:

• Uneven or slippery terrain, roots, rocks, fallen logs, streams, trails

• Encounters with wildlife, insects, plants (including poisonous or allergenic varieties)

• Weather‑related hazards (heat, cold, wind, rain)

• Cuts, scrapes, sprains, fractures, or more serious injury

• Remote location and delayed access to emergency services

I knowingly and freely accept all such risks, both known and unknown, and assume full responsibility for my participation.

2.   Release & Waiver of Liability

I, on behalf of myself, my heirs, personal representatives, and assigns, hereby release, waive, discharge, and covenant not to sue Elizabeth Burdock, her agents, employees, contractors, volunteers, and any associated entities (the “Released Parties”) for any and all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss, damage, injury, or death that may be sustained by me, or to any property belonging to me, whether caused by negligence of the Released Parties or otherwise, while participating in the Activities.

3.   Indemnification

I agree to indemnify and hold harmless the Released Parties from any loss, liability, damage, or costs, including court costs and attorneys’ fees, that may incur due to my participation in the Activities, whether caused by negligence of Released Parties or otherwise.

4.   Medical Authorization

I represent that I am in good health and have no physical or medical conditions that would prevent my safe participation. In the event of injury or illness, I authorize the Released Parties to secure from any licensed hospital, physician, or medical personnel any treatment deemed necessary for my immediate care, and I agree that I will be responsible for payment of all medical services rendered.

5.   Personal Insurance

I understand that the Released Parties do not carry or maintain medical, disability, or liability insurance for me. I confirm that I have adequate personal insurance to cover any injury or damage I may cause or sustain.

6.   Rules of Conduct & Safety

I agree to follow all instructions, warnings, and rules given by Elizabeth Burdock or her representatives, and to conduct myself in a safe and respectful manner at all times. I will inform the guide promptly of any discomfort, condition, or concern that may arise.

7.   Photo & Media Release (Optional)

I consent to be photographed, filmed, or recorded during the Activities for use in promotional materials.I do not consent.

8.   Governing Law & Severability

This Waiver & Release shall be governed by the laws of British Columbia. If any provision is found unenforceable, the remaining provisions shall remain fully in force.

9.   Acknowledgment of Understanding

I have read this entire document, fully understand its terms, and submit it freely and voluntarily without any inducement.

Confirmation

I have read and agree to everything outlined on this page in the Waiver, Risk & Conduct Agreement.