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01/24/2011
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Release of Liability, Waiver and Assumption of Risk Agreement
In consideration of being allowed to participate in Breathwork, as well as activities with SENSOPHY, (hereinafter collectively “the Activities”) I hereby acknowledge, understand and agree to the following:
Breathwork may result in dramatic energetic, physical and emotional release. It is not recommended for persons with a history of cardiovascular disease, those with cardiac arrhythmia (including slow heart rate), history of heart block, epileptic seizures, retinal detachment, high blood pressure, glaucoma, significant recent physical injuries or surgery.
Breathwork is not recommended for persons with extreme mental illness, or for persons using antipsychotic medications or history of aneurysms. Both persons with asthma and women who are pregnant are advised against practicing until they consult with their primary care physician.
(1) I HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS SENSOPHY and its employees, agents, representatives, team members, as well as its owners, principals, and representatives (hereafter collectively “SENSOPHY RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, whether physical, mental, psychological or emotional, or ANY LOSS or DAMAGE to PERSON or PROPERTY, of any kind, WHETHER ARISING FROM THE NEGLIGENCE OF SENSOPHY RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
(2) I am here to inspire my own personal transformation. I take personal responsibility for my well-being and with respect for myself I gratefully accept control of my choices. My heirs, guardians, legal representatives, and I hereby and forever release, waive, and discharge any claims against, “SENSOPHY RELEASEES” and/or any of their associates or affiliates. I take full responsibility and am responsible for all liability for loss or injury incurred while in association with the Activities.
(3) I agree to defend, indemnify, and hold harmless SENSOPHY RELEASEES for all costs and expenses, including but not limited to all legal fees incurred by SENSOPHY RELEASEES in defending any claim brought against any or all of SENSOPHY RELEASEES.
(4) I fully understand that there are physical and inherent risks involved in the Activities, including the risk of serious injury and death. I fully assume all risks associated with the Activities, including: intensive activity and exertion, causation or aggravation of a physical injury or medical condition, lack of warnings or inadequate warnings; lack of instructions, inadequate instructions, or my failure to follow instructions. I am fully aware of and accept the risks and hazards involved, and agree to assume full responsibility for any risks, conditions, injuries or damages, known or unknown, which I might incur or aggravate as a result of my participating in the Activities.
(5) I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Activities. I represent and warrant that I am physically, mentally and emotionally fit and I have no medical condition that would prevent my full participation in the Activities and that I will fully inform SENSOPHY RELEASEES if I feel any pain or discomfort or have any medical or pre-existing condition that would prevent my participation or increase the likelihood of injury.
(6) In consideration of being permitted participation in the Activities, classes, workshops or programs offered by SENSOPHY RELEASEES, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the Activities.
(7) In further consideration of being permitted to participate in the Activities, I knowingly, voluntarily and expressly waive any claim I may have against SENSOPHY RELEASEES for injury or damages that I may sustain as a result of participating in the Activities now and in the future.
(8) I agree to comply with the stated and customary guidance and norms of participation in the Activities.
(9) If I am pregnant or am post-natal, I will not participate in the Activities without first discussing the risks with my primary care physician, and I will only participate in the Activities if I have my doctor’s full approval. I will not hold the SENSOPHY RELEASEES responsible for any injuries to my pregnancy caused in part or in whole by my failure to follow my doctor’s recommendation.
(10) I hereby forever and irrevocably waive and release any and all claims I now have or may in the future have against SENSOPHY RELEASEES with respect to any injury, loss or damage I suffer as a result of participating in the Activities. I understand and agree that this Release of Liability, Waiver and Assumption of Risk Agreement extends to and includes any and all damages, injuries, and claims which I do not anticipate or know to exist and to any and all damages, injuries, or claims which may develop in the future, and I hereby expressly waive and relinquish any and all rights under any law or statute to the contrary.
(11) I understand that this waiver can be used for future classes, workshops or programs with SENSOPHY RELEASEES.
(12) If participant is under the age of 18, I as a LEGAL GUARDIAN CONSENT TO THE ABOVE TERMS AND CONDITIONS.
(13) I have carefully read this agreement and fully understand its content. I am aware that this is a waiver and release of potential liability and a contract between the above noted parties and myself. I understand that this contract is binding and acknowledge that I am signing this of my own free will, voluntary without any inducement. I understand that there exist known and unknown dangers of serious injury and death associated with the Activities, some of which are referenced above, I nevertheless choose to participate in the Activities and have waived all right to maintain suit against any of SENSOPHY RELEASEES.
By ticking the box, you are indicating that you understand all of the information above and are in agreeance with it.
Release of Liability, Waiver and Assumption of Risk Agreement
In consideration of being allowed to participate in Breathwork, as well as activities with SENSOPHY, (hereinafter collectively “the Activities”) I hereby acknowledge, understand and agree to the following:
Breathwork may result in dramatic energetic, physical and emotional release. It is not recommended for persons with a history of cardiovascular disease, those with cardiac arrhythmia (including slow heart rate), history of heart block, epileptic seizures, retinal detachment, high blood pressure, glaucoma, significant recent physical injuries or surgery.
Breathwork is not recommended for persons with extreme mental illness, or for persons using antipsychotic medications or history of aneurysms. Both persons with asthma and women who are pregnant are advised against practicing until they consult with their primary care physician.
(1) I HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS SENSOPHY and its employees, agents, representatives, team members, as well as its owners, principals, and representatives (hereafter collectively “SENSOPHY RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, whether physical, mental, psychological or emotional, or ANY LOSS or DAMAGE to PERSON or PROPERTY, of any kind, WHETHER ARISING FROM THE NEGLIGENCE OF SENSOPHY RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
(2) I am here to inspire my own personal transformation. I take personal responsibility for my well-being and with respect for myself I gratefully accept control of my choices. My heirs, guardians, legal representatives, and I hereby and forever release, waive, and discharge any claims against, “SENSOPHY RELEASEES” and/or any of their associates or affiliates. I take full responsibility and am responsible for all liability for loss or injury incurred while in association with the Activities.
(3) I agree to defend, indemnify, and hold harmless SENSOPHY RELEASEES for all costs and expenses, including but not limited to all legal fees incurred by SENSOPHY RELEASEES in defending any claim brought against any or all of SENSOPHY RELEASEES.
(4) I fully understand that there are physical and inherent risks involved in the Activities, including the risk of serious injury and death. I fully assume all risks associated with the Activities, including: intensive activity and exertion, causation or aggravation of a physical injury or medical condition, lack of warnings or inadequate warnings; lack of instructions, inadequate instructions, or my failure to follow instructions. I am fully aware of and accept the risks and hazards involved, and agree to assume full responsibility for any risks, conditions, injuries or damages, known or unknown, which I might incur or aggravate as a result of my participating in the Activities.
(5) I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Activities. I represent and warrant that I am physically, mentally and emotionally fit and I have no medical condition that would prevent my full participation in the Activities and that I will fully inform SENSOPHY RELEASEES if I feel any pain or discomfort or have any medical or pre-existing condition that would prevent my participation or increase the likelihood of injury.
(6) In consideration of being permitted participation in the Activities, classes, workshops or programs offered by SENSOPHY RELEASEES, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the Activities.
(7) In further consideration of being permitted to participate in the Activities, I knowingly, voluntarily and expressly waive any claim I may have against SENSOPHY RELEASEES for injury or damages that I may sustain as a result of participating in the Activities now and in the future.
(8) I agree to comply with the stated and customary guidance and norms of participation in the Activities.
(9) If I am pregnant or am post-natal, I will not participate in the Activities without first discussing the risks with my primary care physician, and I will only participate in the Activities if I have my doctor’s full approval. I will not hold the SENSOPHY RELEASEES responsible for any injuries to my pregnancy caused in part or in whole by my failure to follow my doctor’s recommendation.
(10) I hereby forever and irrevocably waive and release any and all claims I now have or may in the future have against SENSOPHY RELEASEES with respect to any injury, loss or damage I suffer as a result of participating in the Activities. I understand and agree that this Release of Liability, Waiver and Assumption of Risk Agreement extends to and includes any and all damages, injuries, and claims which I do not anticipate or know to exist and to any and all damages, injuries, or claims which may develop in the future, and I hereby expressly waive and relinquish any and all rights under any law or statute to the contrary.
(11) I understand that this waiver can be used for future classes, workshops or programs with SENSOPHY RELEASEES.
(12) If participant is under the age of 18, I as a LEGAL GUARDIAN CONSENT TO THE ABOVE TERMS AND CONDITIONS.
(13) I have carefully read this agreement and fully understand its content. I am aware that this is a waiver and release of potential liability and a contract between the above noted parties and myself. I understand that this contract is binding and acknowledge that I am signing this of my own free will, voluntary without any inducement. I understand that there exist known and unknown dangers of serious injury and death associated with the Activities, some of which are referenced above, I nevertheless choose to participate in the Activities and have waived all right to maintain suit against any of SENSOPHY RELEASEES.
By ticking the box, you are indicating that you understand all of the information above and are in agreeance with it.
Error: Contact form not found.
Error: Contact form not found.
Informed Consent + Liability Waiver *
Breathwork is a healing technique using your own breath to move energy within your body. It can unblock the flow of energy creating a variety of effects. Such effects can include (but are not limited to) the following: tightness in hands, mouth, or tension in parts of the body during the session accompanied by emotional releases.
The client agrees that using any of these mentoring or Breathwork services are entirely at his/her own risk. These services are provided “as is,” without warranty of any kind, either expressed or implied, including without limitation any warranty for information services, mentoring, uninterrupted access, or products and services provided through or in connection with the service. This service is requested at the client’s own choice and with inherent singular responsibility.
The client agrees that the use of all, or part, of the service is entirely at the client’s own risk. Any actions or lack of actions, taken by the client of such advice is done so solely by choice and responsibility of the client and is neither the responsibility nor liability of Sensophy.
The client accepts full responsibility waiving all rights to liability or any claims against Sensophy. The client, his/her/hir parent/guardian, his/her/hir heirs, or legal representatives forever release, waive, discharge and covenant not to sue Sensophy, for any injury, harm or death caused by either negligence or other acts. The client has read and understood this form and all its contents, and the client voluntarily agrees to the terms and conditions stated above.
Error: Contact form not found.
Informed Consent + Liability Waiver *
Breathwork is a healing technique using your own breath to move energy within your body. It can unblock the flow of energy creating a variety of effects. Such effects can include (but are not limited to) the following: tightness in hands, mouth, or tension in parts of the body during the session accompanied by emotional releases.
The client agrees that using any of these mentoring or Breathwork services are entirely at his/her own risk. These services are provided “as is,” without warranty of any kind, either expressed or implied, including without limitation any warranty for information services, mentoring, uninterrupted access, or products and services provided through or in connection with the service. This service is requested at the client’s own choice and with inherent singular responsibility.
The client agrees that the use of all, or part, of the service is entirely at the client’s own risk. Any actions or lack of actions, taken by the client of such advice is done so solely by choice and responsibility of the client and is neither the responsibility nor liability of Sensophy.
The client accepts full responsibility waiving all rights to liability or any claims against Sensophy. The client, his/her/hir parent/guardian, his/her/hir heirs, or legal representatives forever release, waive, discharge and covenant not to sue Sensophy, for any injury, harm or death caused by either negligence or other acts. The client has read and understood this form and all its contents, and the client voluntarily agrees to the terms and conditions stated.