Energy Healing Waiver Release of Liability
Client Name: | [Client's Full Name] |
Date: | [Date of Signing] |
Practitioner: | [Your Name] |
I. Description of Services
I, [Client's Name], acknowledge that I have voluntarily requested and consented to receive energy healing services from [Your Name], which may include various forms of energy work, such as Reiki, chakra balancing, or other similar modalities.
II. Acknowledgment of Risks
I understand and acknowledge that energy healing involves holistic practices that are complementary to conventional medicine but are not a substitute for licensed medical or psychological care. I recognize that there are inherent and potential risks associated with energy healing, including but not limited to:
Emotional or psychological discomfort
Intensification of existing emotions
Physical sensations or discomfort
Release of stored emotions
I am fully aware and understand that certain kinds of experiences can potentially take place either during an energy healing session or perhaps after it has concluded. Furthermore, I comprehend that these experiences may be unanticipated and may be unfamiliar or strange to my understanding and experience.
III. Release of Liability
In consideration of receiving energy healing services from [Your Name], I hereby release, waive, discharge, and covenant not to sue [Your Name], their employees, agents, or volunteers from any liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or to any property belonging to me arising out of, or related to, the energy healing services provided.
IV. Assumption of Risk
I want to make it known and completely understood that I am willingly engaging in energy healing sessions. I am not entering this blindly but with an awareness and comprehension of the possible risks that this type of service may carry. It is crucial to note that I am consciously taking on any responsibility for any risks that may arise from participating in these sessions. In the event of any unfortunate circumstance such as loss of property, personal injury, or in the worst-case scenario, death—I am fully aware that it is solely my responsibility. I am choosing to voluntarily assume these risks by deciding to receive the energy healing services.
V. Indemnification
I hereby acknowledge and express my willingness to compensate for any potential loss, assume responsibility for any liability or damage, or cover any costs that may arise, inclusive of the costs attached to legal court proceedings and attorney's fees, which may transpire as a direct consequence of my involvement in energy healing services provided by [Your Name]. Furthermore, I also agree to absolve and protect [Your Name] from any blame or harm arising from the above-mentioned circumstances.
VI. Informed Consent
I am putting my signature on this Energy Healing Waiver Release of Liability document as an explicit confirmation that I have been adequately informed about the nature of the energy healing services that I am about to receive, along with a clear explanation of their purpose. I have been informed in detail about the inherent risks involved in such services. Additionally, I have been provided with the opportunity to ask any questions related to these services. To all of these questions, I have received answers that were sufficiently satisfactory and illuminating.
VII. Legal Age and Authority
I hereby solemnly affirm and declare that I have reached the legally acceptable age that renders me competent to provide an official signature on this waiver. Should this signature be required on behalf of an individual who is a minor or an individual who is incapable of providing their consent, I stand firm in my affirmation that I carry the legally mandated authority to execute such an action.
VIII. Agreement
I hereby affirm that I have personally reviewed and comprehensively understood every term stated in this Energy Healing Waiver Release of Liability. I am acknowledging at this moment that the decision to sign this document has been made independently, freely, and voluntarily without any coercive influence. Furthermore, I have the intention of being legally bound by the terms and conditions contained within this document, fully realizing that the signing of this document correlates to the acceptance and affirmation of said terms.
Client's Signature:
[CLIENT'S NAME]
[DATE]
Practitioner's Signature:
[YOUR NAME]
[DATE]
Witness's Signature (if applicable):
[WITNESS'S NAME]
[DATE SIGNED]
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