BALI-form <- PRINT OUT AND FILL IN FORM

ADDITIONAL NOTES

Which retreat is this for please mark one or more

Ancestral Journey of the Heart Dec 28- Jan 6,2019_________

Bali Sacred Immersion Feb 13-25,2019_______

Journey of the Heart:Bali Bliss  Mar 13-25,2019__________

Please return these signed document regarding TRAVEL DOCUMENTATION
MEDICAL INFORMATION
DIETARY NEEDS

ASSUMPTION OF RISK AND RELEASE OF LIABILITY

by either e-mail or post to Heart of the Jungle, Inc.
as soon as you can no later than One month before retreat
Heart of the Jungle, Inc. PO Box 1567, Makawao, HI 96768, USA

E-mail Sol33king@gmail.com

Airline reservations made sooner than later to secure your best price on Round trip to Denpasar, Bail, Indonesia Code DPS (Name of airport you land) is advisable. The balance of your payment is due in Bali when retreat begins There are lots of deals online for airline tickets  I have used asaptickets.com and skyscanner.com for great deals.

Please make checks out to Heart of the Jungle Send to PO Box 1567 Makawao, HI 96768.
Please be sure that it is sent in a way that we are able to sign for it, for your protection.

Everyone must present a valid credit card as they register at the front desk. Your credit card will only be charged for incidentals or any extras you may decide to purchase during your stay.

The group price is for arrival date thru Ending date at noon retreat ends.

All lodging etc. before that and after Retreat will be on your own.

Please Contact Solomon if you are coming earlier or staying later for Him to make arrangements for you.

Information needed for all retreats  Page 1

Name Passport No. Nationality Expiry Date

__________________________________ __________________________________ __________________________________ __________________________________

Departure City Departure Date Airline/ Flight No. Arrival Date /Time Return Date Return Flight Time

__________________________________ __________________________________ __________________________________ __________________________________ __________________________________ __________________________________

TRAVEL DOCUMENTATION

Expiry Date MUST READ at least 6 months PAST  your date of departure from bali. If you are uncertain please contact Solomon Please check your passports prior to travel.

BALI ADDITIONAL INFORMATION

Page 2

MEDICAL INFORMATION

Doctor’s Name _________________________________________ Phone _________________________________________

Are you taking any special medications? If so, what? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

Do you have any allergies? If so, what? ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

Do you have impaired vision? Glasses or contacts? __________________________________________________________

Do you have physical impairments or disability? If so, explain. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

BALI –  ADDITIONAL INFORMATION Page 3

DIETARY NEEDS

It is important to know your dietary needs so that we can communicate with our hotel and restaurants. Please be as detailed as you can be if you are on a special diet.
Do you have any FOOD allergies or are you on a special diet?

Please  explain

 

Please check all that apply to your diet

Vegetarian (Dairy & Eggs OK)__________

Vegan (No Animal Products)___________
I Eat Everything and Love it All__________

Sensitive to Spicy Foods____________

Chicken OK / NO
Seafood OK / NO
Red Meat OK / NO

Do you have any other special needs you would like to share with us? If so, please explain. ___________________________________________________________ ___________________________________________________________ ___________________________________________________________

BALI – Additional Information Page 4

ASSUMPTION OF RISK AND RELEASE OF LIABILITY

I do hereby agree to take complete and total responsibility for my actions on the Retreat produced by Journey of the heart, Bali Hati

I hereby agree to release and discharge  A. Solomon Sikirdji (tour guide),  or any representative of Heart of the Jungle, Inc, on behalf of myself, my children, my parents, my spouses, my immediate and extended family, my heirs, assigns, personal representatives and estate, as follows:

I acknowledge that there are known and unanticipated risks which could result in physical and/or emotional injury, paralysis, death or damage to myself.

The risks include, among other things, slipping and falling, falling rocks, water hazards, high altitudes, other people’s negligence or my own negligence.

I expressly agree and promise to accept and assume all risks existing in, or arising during this event. I hereby take complete and total responsibility for my actions during this event and release Heart of the Jungle, Inc. from any and all claims of liability arising from this event.

I certify that I am in good health (both physically and emotionally) and capable of participating in this event. I understand that it is solely my responsibility to determine whether there is any medical reason that I should not participate in this event or any activity of this event. I understand this event will include some hiking on unmaintained trails. I also understand that all activities in this event are voluntary, and I reserve my right to refuse to participate in activities that may endanger my good health or that are beyond my capabilities (either physically or emotionally).

I hereby voluntarily release, forever discharge and agree to indemnify and hold harmless Heart of the Jungle,Inc., its directors, officers and shareholders from any and all claims, demands or causes of action, whether from bodily injury, loss, or otherwise, which are connected with my participation in the  retreats produced by Journey of the Heart This includes any claims which allege negligent acts of omissions by Heart of the Jungle, Inc.

I acknowledge with certainty that I have had sufficient opportunity to read this entire document. Signature ________________________________________________________________________ Print Name ________________________________________________________________________ Street Address ________________________________________________________________________ City __________________________ State _________________________ Zip _________________ Phone _______________________________
IN CASE OF EMERGENCY CONTACT: Name ________________________________________ Phone (home) _____________________________ (cell) _____________________________________ MEDICAL CONDITIONS HEART OF JUNGLE, INC. TO BE AWARE OF: _____________________ _____________________________________________________________________________________

BALI – ADDITIONAL INFORMATION Page 5

Important Things to Consider:

PASSPORT – Must be valid for 6 months PAST your exit of Indonesia at least. Make two copies, one for safekeeping and one to give to us upon arrival.

BAGGAGE ‐ Please check with your airlines prior to departure regarding their baggage restrictions. Many airlines are now allowing only one bag per passenger and extra charges for additional bags. Check with your airlines and plan accordingly. Additionally, you may want to pack a collapsible duffle bag to fill with your purchases and carry home.

RETURN TICKET – You must show customs your return ticket upon arrival to Bali. Please make sure you have it with you or at least a copy of your e‐ticket.

VISA – Upon arrival you will be given a FREE visa good for 30 days. If you are planning to stay longer than 30 days please contact Solomon at your earliest convenience for further instructions.

MONEY – You will get a lower rate of return with Traveler’s Checks. The best rate of return would be in the form of $100 dollar bills. You must ask your bank for the newest ones,preferably perfect with no marks, rips etc ; if your bank asks you why you need this  simply state you are travelling to Indonesia and these bills get the best conversion rate. If you end up with older series bills, your rate will be much lower and you cannot change them at just any place.

Cash is easiest in Bali and the hotel will provide a safe.
Average spending money per day, without purchases, is about $30 US per day. Of course, if you plan to shop or visit the spa you will need more.
At the present time, $1US is equivalent to approx 13,000 Indonesian Rupiahs. The rate fluctuates daily. To see what your money is worth in Indonesia you may visit any online currency conversion site such as www.xe.com/ucc.   Some people prefer to use credit cards I myself do not as sometimes problems  so choice is yours.  There are ATM Machines in Ubud area however sometimes they eat your card so could be problem  hence I use cash direct and simple.

WEATHER CONDITION – Bali is in the tropics. Please pack accordingly. It is very warm during the day (around 80 degrees) and can get cooler at night (between 50 – 60). You will want a light cover‐up, umbrella and lightweight long pants to protect you from mosquitoes or the sun. Shorts and tank tops are acceptable most anywhere except Temples. Any type of clothing is available in Ubud, so you may always shop if you forget something.

DRINKING WATER – We will provide a 5‐gallon container of pure drinking water available for refilling your water bottles. Do not put water in your mouth while showering, brushing your teeth or swimming. Use only bottled water for anything you need.

BALI – ADDITIONAL INFORMATION Page 6

TEMPLE VISITS – Please note that for special ceremony or temple visits, covered shoulders are required of both men and women. We will provide 2 sarongs and sashes for these visits. Men should wear a light dress shirt and women are required to wear sleeves – NO tank tops allowed in temples. (You may want to buy others.)

SHOPPING – There are a variety of stores in Ubud and you can find most anything. Please note that western type sunscreen and medications are very expensive. You may also find what you need among your fellow group members if you forget something.
You might consider purchasing a book about Bali from Lonely Planet to familiarize yourself with local customs and all small details.

Here is a checklist for your convenience:

Bathing Suit
Travel towel
Small backpack, daypack or fanny pack for our daytrips
Sunhat or visor
Sunscreen
Comfortable walking shoes or sandals
Compact Umbrella
Warm long sleeve for night time (maybe just the one you wear on the plane)
Bring a shawl, a sweater, sometimes it you may get chilly indoor air‐conditioned restaurants. Women Please bring one or two blouses with some sort of sleeve. Men have 2 shirts with short sleeves for temple visits
Toiletries you need including contact lens supplies
Medications (including some diarrhea pills in case of “bali belly”)
Homeopathic remedies such as Traumeel or Rescue Remedy crème,

which can be used on bug bites
Healthy Snacks (if you just can’t live without your power bars or whatnot)
Herbal Tea you enjoy (only black tea is available most places)
Camera
Batteries if you need them
Power converter, if you need it, and two‐pin plug converter for 220 volts
Antiseptic wipes
Insect repellent
Nalgene‐type water bottle for refilling and sparing the environment
Flashlight (something you can carry with you, streets are not always well‐lit)
Internet is widely available and wireless is also available, you may bring your laptop

Internet can be slow to sketchy so do not plan on doing a lot of internet work.

ANY questions or concerns PLEASE contact Solomon at. Sol33king@gmail.com.  808-295-0001 from oct 28 till approx dec 22,2018