WELCOME TO PUERTO RICO!
We are so excited that you have taken the time to take care of you. Getting away from the pressures of life is so vital to recharge. We are honored that you have chosen Paradise Wellness to escape to and enjoy and learn about the abundance of living a healthy lifestyle. We find that the world is moving toward a healthier regime and incorporating as much alkalizing enzyme rich food is going to be the ideal way to maintain health and fight disease.
All we ask is that you go with the flow, ask lots of questions, be honest with your body, and listen to Nature!
PARADISE WELLNESS REGISTRATION AND HEALTH FORM
This form will provide us with insight about your current state of health.
Telephone #_Telephone #
Date of Birth_Date of Birth
Diet Information: Breakfast, Lunch, Dinner, Snacks.Please describe your typical diet and give us an idea of what you eat. Include beverages. Vegetarian, Meat Eater, Flexitarian, etc._Diet Information
Alcohol Yes No Frequency_Alcohol
Coffee Yes No Frequency_Coffee
Caffeinated Tea Yes No Frequency_Caffeinated Tea
Bread Yes No Frequency_Bread
Tobacco Products Yes No Frequency_Tobacco Products
Sodas Yes No Frequency_Sodas
Milk/Cheese/Dairy Yes No Frequency_Milk/Cheese/Dairy
Soy Products Yes No Frequency_Soy Products
Baked Goods Yes No Frequency_Baked Goods
Sugar Yes No Frequency_Sugar
Are you presently taking over the counter medication? Recreational Drugs?
If yes please list_Are you presently taking over the counter medication? Recreational Drugs?
Are you presently taking any prescription drugs?
If yes, List_Are you presently taking any prescription drugs?
Do you experience side effects from prescription drugs?
If yes, List_Do you experience side effects from prescription drugs?
Do you have any allergies? Yes or No
If yes list_Do you have any allergies? Yes or No
Inhaler Yes No Frequency_Inhaler
Do you experience brain fog, dizziness or drowsiness? Yes No Frequency_Do you experience brain fog, dizziness or drowsiness?
What dates would you like to visit?_What dates would you like to visit?
What type of retreat is it?_What type of retreat is it?
What are your expectations?_What are your expectations?
What emotional stressors do you need to release while you are here, if any?_What emotional stressors do you need to release while you are here, if any?
Please note that Paradise Wellness is an island rejuvenation retreat; we are NOT a clinic or medical facility. We do not offer medical advice or intervention and we have no medical doctors on site; however we can make arrangements for you to visit a local physician or emergency medical facility if you find it necessary.
If you currently have a medical condition, please consult your physician to determine if our programs are appropriate for you. You will be required to sign a disclaimer releasing Paradise Wellness from any responsibility for any health conditions you experience, pre-existing or otherwise.
We require a NON REFUNDABLE 50% deposit at time of booking and the balance two weeks before your scheduled retreat. Much goes into the planning of your wellness experience and we cannot offer a cash refund. If you are unable to attend your scheduled retreat, you may come at any time later up to one year. We accept payment by credit card via Pay Pal.
I have read and understand the above terms of my stay at Paradise Wellness in Luquillo, Puerto Rico.
Emergency Contact Info
Please contact_Please contact
Phone number_Phone number
City, ST_City, ST
PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK
In consideration of the services of Paradise Wellness, its agents, owners, officers, volunteers, participants, employees, and all other persons or entities acting in any capacity on its behalf, I hereby agree to release, indemnify, and discharge Paradise Wellness, on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows:
By signing this document I acknowledge that if anyone is hurt or property is damaged during my participation in this activity, I may be found by a court of law to have waived my right to maintain a lawsuit against Paradise Wellness on the basis of any claim from which I have released them herein.
I have had sufficient opportunity to read this entire document. I have read and understand it, and I agree to be bound by its terms.
Signature of Participant:_Signature of Participant:
Print Name:_Print Name:
Phone #_Phone #
Email address:_Email address:
WHAT TO BRING
Our packing list includes what to bring not only to enjoy your stay here at Paradise Wellness, but also should you decide to embark on any other ventures around Puerto Rico.
Our wish is to prepare you for the most memorable healing vacation of your life, and assist you to prepare ahead. Once you have prepared well for your inner healing journey, you can leave your rational mind behind, and really let go! We have compiled a list of items that we wouldn't leave home without! Our weather can change rapidly and it tends to be warm during the day when the sun is up, and a little chilly when it goes down. It can rain at any moment, due to the fact that we are located less than a mile from the rainforest. But the rain usually lasts for a short while.
Preparing your luggage:
Always place an identifiable marker on your luggage (red polka dot ribbon, etc.) Compile your Health Insurance Information on your person, for travel and to have available should we need for your health safety.
Planning your wardrobe:
For all of your activities you will only need the most basic set of items. Always be prepared. Your length of stay, will affect the amount to pack, but remember that you will have access to our on-site laundry room so don't over pack! Remember to keep it simple. And should you need any additional items, there is a local Walgreens and Kmart a few miles away.
Here is an ideal list of things to pack:
Sandals or Flip flops
Hiking shoes, Lightweight with traction, able to get wet OR
Athletic Shoes, a pair of comfortable sandals (sandals that allow for walking in water is handy for hiking)
Casual Comfortable Clothing (Island Wear): Shorts, Tees, Light pants, Summer Dresses
Athletic wear of choice (sports bra for yoga and stretching)
Brim hat for sun protection
Cell phone and charger, toiletry bag, RX medications, herbal remedies, vitamins, Camera and battery back-up/charger, Journal and writing utensils, reusable water bottle,all natural mosquito spray or oils, preferably with no chemicals, and all natural sunblockand sunscreen. Bring pictures of your family and friends…makes for great conversations. You can also bring your Laptop for personal web use...we have wireless internet.
Out of consideration to those around you, and your own inner peace, we recommend that our guests need not bring the following items:
Perfumes, and synthetic hair or body products, aerosols, jewelry and other valuable. All your cosmetics should be all-natural, containing no parabensand unnecessary chemicals. Let us know if you need suggestions.
Paradise Wellness Transition Program
One to two weeks before you will be in sunny Puerto Rico, hiking in the rainforest, swimming at the beach and consuming a 100% raw and living foods diet, you will need to transition away from the standard fare you are most familiar with. This will aid in your ease into our program. Detox will be lighter and your appetite will be less voracious for the “other” foods. Once you get here, our meals are nourishing and quite filling even though you will feel much lighter than usual. In addition your body will begin to cleanse and detoxify with this lifestyle change, which is a wonderful way to ease into the new healthier you.
Regardless of your eating style, please take at least one week to “transition” and prepare your body for your all raw experience. Please begin by:
ASHE! (and so it is!)
Raw Food and Juicing Adventure in Puerto Rico
Friday, Dec 27, 2013
Saturday, Dec 28
Sunday, Dec 29
Monday, Dec 30
Tuesday, Dec 31st
Wednesday, Jan 1, 2014
Thursday, Jan 2