Pre-Retreat Questionnaire Yay!!!! We can’t wait to welcome you here. You’ve made an excellent choice! We invite you to tell us as much as possible about yourself so we can already start individualizing your stay with us. All information is confidential. The Breathe In Greece TeamPlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastAddressAddress Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhoneEmail *Date of BirthEmergency ContactName (First/Last)Emergency PhoneRelationshipSpouseSisterBrotherSonDaughterFriendOtherEmergency EmailArrival DetailsDate / Time *DateTimeArrival Flight (Domestic)SKY Express - GQ450Olympic Air (Aegean) - OA40OtherWhich Flight?Departure DetailsDate / Time *DateTimeDeparture Flight (Domestic)SKY Express - GQ450Olympic Air (Aegean) - OA40OtherWhich Flight?Medical HistoryGenderMaleFemaleOtherI prefer not to sayDo you have, or have had any medical conditions?NoYesPlease state your medical conditions hereOther Medical Issues?NoYesState your medical issues hereAny recent surgeries?NoYesState your surgeries hereAre you taking any medication (or have in the last six months)?NoYesState your medication hereAre/could you be pregnant now or have you had a baby in the last 12 months?NoYesDo you have any food allergies/intolerances/preferences? *NoYesState your preferences hereFitness level-What sports/activities do you participate in?Level of Yoga practiceNoviceIntermediateAdvancedHealth Disclaimer Physical activities, in all their forms and with or without the use of equipment (i.e., classes may include blocks, straps or any other equipment that the instructor may suggest), is a strenuous physical activity. Accordingly, you are urged and advised to seek the advice of a physician or health and fitness professional before the retreat or otherwise begin any physical exercise regimen, routine, or program through the services (such as yoga and pilates classes)—THALASSA BLUE Inc. and BREATHE IN GREECE are not a medical or mental health organization and its instructors or staff cannot give you medical or psychological/psychiatric advice or diagnosis. Any advice received should not be relied upon for your personal, medical, or psychological well-being or for any other reason, and you should consult an appropriate professional for specific advice tailored to your situation. With respect to any physical activities, all comments relating to the use of equipment, poses, moves and instruction are not required to be performed by you and are carried out at your election while in the class. Nothing contained on the site or other products or services offered by THALASSA BLUE Inc. and BREATHE IN GREECE should be construed as any form of such medical or mental health advice, diagnosis or substitute for professional consultation. By using the Services you represent that you understand that physical exercise involves strenuous physical movement and that such activity carries the risk of injury, whether physical or mental capabilities of such activities. You are responsible for ensuring that by participating in classes and activities from THALASSA BLUE INC. and BREATHE IN GREECE, you will not exceed your limits while performing such activities. You will select the appropriate level of classes for your skills and abilities, as well as for mental or physical conditions and/or limitations you may have. You understand that, from time to time, instructors may suggest physical adjustments or the use of the equipment, and it is your sole responsibility to determine if any such suggested adjustment or equipment is appropriate for your level of ability and physical and mental condition. You expressly waive and release any claim that you may have at any time for injury of any kind against THALASSA BLUE INC. and BREATHE IN GREECE, or any person or entity involved with THALASSA BLUE INC. and BREATHE IN GREECE, including without limitation its directors, principals, instructors, independent contractors, employees, agents, contractors, affiliates and representatives.Please confirm your option *I Agree to Health DisclaimerI Do Not Agree to Health DisclaimerCancellation By You You may cancel your booking at any time. Depending on when you cancel, cancellation fees may apply. We highly recommend travel insurance for all clients. This must be bought independently as it is not included in the retreat price. If for whatever reason, you need to cancel your retreat place after you have booked with us, the following refund policy will apply: All cancellations must be received in writing. If you cancel between 59-0 days before the start of the retreat, we will retain 100% of the cost of the retreat. If you cancel between 60 to 89 days before the retreat start date, 25% of the entire retreat amount will be refunded to you. If you cancel between 90 to 119 days before the retreat start date, 50% of the entire retreat amount will be refunded to you. If you cancel 120 days or more before your retreat start date, you will be refunded the full retreat amount (minus your seven hundred dollars ($700) non-refundable booking fee) with no cancellation fee. No refund will be provided for premature leaving of the retreat or failure to arrive at the retreat for any reason. No refund will be provided for only part of a booking, for example, if a room is booked for two guests who are sharing and one guest is unable to attend, the booking would need to be cancelled as a whole for the above refund policy to apply. No refund will be provided for any room downgrades after the 24hrs from the point of booking has lapsed. If paying via installments, the above conditions will apply based on the entire price of your booking and not just on any installments paid. If paying via installments due to administration, an additional 5% will be charged on all stage payments. If another person can be found to take your place, then we may offer you a partial or full refund at our discretion. Refunds and returned payments are generally settled within 120 working days of the date of cancellation. Once the retreat has begun, no refund or part refund or unused portion of the retreat will be repaid in the event of cancellation by you. Bookings are for the stated period of the retreat. There are no refunds for an unused portion of the retreat. If the reason for cancellation is covered under the terms of your Insurance Policy, you may be able to claim your insurance. Cancellation By Us THALASSA BLUE Inc. and BREATHE IN GREECE always cater to the best of their guests, and cancelling a retreat will always be the very last option. However, if THALASSA BLUE Inc. and BREATHE IN GREECE must cancel or change a scheduled retreat date for any reason whatsoever, you’re entitled to transfer your full retreat payment to another retreat (either scheduled or at some future time). Alternatively, you may request a refund of your applicable payment. THALASSA BLUE Inc. and BREATHE IN GREECE are not responsible for your expenses incurred in preparation for any cancelled retreat, such as other accommodation, airline tickets, loss of work, and/or other costs associated with preparing for your trip. THALASSA BLUE INC. and BREATHE IN GREECE are committed to providing the best Services and experience possible and therefore, we must reserve the right to change instructors and/or venue of the Services at any time without any liability to you.Please confirm *I Agree to Cancellation PolicyI Do Not Agree to Cancellation PolicySubmit