Name *

First Name

Last Name

Phone

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LIABILITY RELEASE - By checking this box, I agree with the following terms: * *

I hereby understand and acknowledge that my participation in this or any Reiki treatment, BioMat or Coaching session may expose me to many inherent risks, including accidents, injury, illness, or even death. I assume all risk of injuries associated with participation including, but not limited to, falls, contact with other participants, effects of the treatment, the effects of the weather, including high heat and/or humidity, and all other such risks being known and appreciated by me. I hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in this agreed-to session. This is a complete and irrevocable release and waiver of liability. Specifically, and without limitation, I, on behalf of myself, hereby release the Released Parties from any liability, claim, or cause of action arising out of the “Released Parties” negligence. I, on behalf of myself; covenant not to sue the Released Parties for any alleged liabilities, claims, or causes of action released hereunder. I further agree to indemnify and hold harmless and defend the Released Parties from any and all claims resulting from injuries or illness (including death), damages, or loss, including, but not limited to attorneys’ fees, sustained by me arising out of, connected with, or in any ways associated with the session. In the event of any emergency, I authorize the Released Parties to secure from any licensed hospital, physician and/or medical personnel any treatment deemed necessary from my immediate care and agree that I will be responsible for payment of any and all medical services rendered. After having read this waiver and knowing these facts, and in consideration of acceptance of my participation, I agree, for myself and anyone entitled to act on my behalf, to HOLD HARMLESS, WAIVE AND RELEASE Hallowed Life Passages and its associates including Deborah M Pierce from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in a Reiki or BioMat session, Coaching work or any other activities that are part Hallowed Life Passages or its associated members, programs and/or events. I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.

I agree to the terms of this waiver.