AGREEMENT OF RELEASE AND WAIVER OF LIABILITY FORM
I understand the Qi-gong and MELTT Practices offered through Healing Circles Langley are donation only and the volunteers provide these offerings free of charge. By participating in these experiences, I will receive information and instruction about a variety of mind, body and spirit practices. I recognize that some of these practices may require physical movement or exertion, which may be strenuous for my body and may cause physical discomfort or injury. I am fully aware of the risks and hazards involved. Some of the practices may work with energy and meditation methods and are offered as practices to build resilience. These practices are not offered as mental health, medical or other professional treatment or advice and should not substitute for professional assistance should I require this. I understand that it is my responsibility to consult with a physician or mental health provider prior to and regarding my participation in these practices.
I agree if I am currently undergoing chemotherapy or other significant health treatments, I will notify a Healing Circles Langley representative, speak with my medical provider and provide Healing Circles Langley, or its host, sponsor or provider a medical approval and release for my participation. Otherwise, I state I am generally physically fit. I have no medical conditions which would prevent my full participation in Qi-gong and MELTT Practices.
In consideration of being permitted to participate in the MELTT or Qigong practices, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of my participation in the program(s).
In further consideration of being permitted to participate in the MELTT or Qigong practices, I knowingly, voluntarily and expressly waive any claim I may have against Healing Circles Langley, it’s directors, boards, class/workshop sponsors or providers, for any injury or damages that I may sustain as a result of participating in the program. On behalf of myself, my heirs or legal representatives, I forever release, waive or discharge any claims of damages, negligent or other acts which I may experience as a result of my participation. I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above by acknowledging via online acceptance during registration and/or as posted in the Zoom chat box at class time or by participating in the class.
I further affirm I am over the age of 18 years old and no approval by a legal guardian is necessary for my participation.