As the client, and in consideration for my participation in breathwork sessions Lynn Gantner, DBA Holistic Heart Breathwork. I agree that my participation in Breathwork, Energy Medicine, Somatic Movement, Biodevelopment, and or coaching is entirely voluntary and that I assume any risk associated with participation. Any actions or lack of actions, taken by me, the client, of such advice is done so solely by choice and responsibility, and any harm, injury, or loss that may occur to me or my property as a result of my participation in Breathwork or Coaching sessions, is neither the responsibility nor liability of Lynn Gantner (DBA, Holistic Heart Breathwork),. Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmlessLynn Gantner (DBA, Holistic Heart Breathwork) from and against any and all claims or liability of whatsoever kind or nature arising out of or in connection with my session(s).
My signature below acknowledges that this agreement includes any independent contractor of Lynn Gantner (DBA, Holistic Heart Breathwork) has no control over, and assumes no responsibility for the acts or omissions of such independent contractors.
I understand that Breathwork, Energy Medicine, Somatic Movement, Biodevelopment, and or coaching is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment, and I will not use it in place of any form of therapy. I recognize that breathwork requires emotional, physical, and mental effort, exertion, and behavioral experimentation on my part, which may cause physical, mental or emotional injury. I fully acknowledge and take full responsibility for all the risks involved. I understand that it is my responsibility to consult with my health care provider before participating in the Practicum.
In the event that I am injured, I agree to assume any financial obligation, either through my personal health insurance or through some other means, for any medical costs I incur. Lynn Gantner (DBA, Holistic Heart Breathwork) assumes no responsibility for any medical expenses, injury, or damage suffered by me in connection with the use of any facilities or services in connection with the Breathwork and or coaching
IN CONSIDERATION OF MY PARTICIPATION IN THE Breathwork, Energy Medicine, Somatic Movement, Biodevelopment, and or coaching, I HEREBY GENERALLY RELEASE, AND PROMISE TO INDEMNIFY, DEFEND, AND HOLD HARMLESS Lynn Gantner (DBA, Holistic Heart Breathwork), AND THEIR RESPECTIVE AGENTS AND EMPLOYEES (THE “RELEASE PARTIES”), FROM ANY LIABILITY WHATSOEVER. I will reimburse Lynn Gantner (DBA, Holistic Heart Breathwork), for any damages, reasonable settlements and defense costs, including attorney’s fees, that they incur because of any such claims made against them. I agree that the terms of this agreement, including the indemnification obligations in this paragraph, will be binding on my estate, and my personal representative, executor, administrator or guardian will be obligated to respect and enforce them. This RELEASE does not extend to claims for gross negligence, intentional or reckless misconduct, or any other liabilities that applicable law does not permit to be excluded by agreement.
I agree that the purpose of this agreement is that it shall be an enforceable RELEASE OF LIABILITY AND INDEMNITY as broad and inclusive as is permitted by California law. I agree that if any portion or provision of this agreement is found to be invalid or unenforceable, then the remainder will continue in full force and effect. I also agree that any invalid provision will be modified or partially enforced to the maximum extent permitted by law to carry out the purpose of the agreement.
I understand that this is a contract that affects my legal rights, and I have read and understood this form and all its contents, and I voluntarily agree to the terms and conditions stated above.
Privacy
All sessions are confidential; group sessions will be recorded and may be shared within the Bloom Boldly and Beautifully membership. I understand that during all Sessions, I MAY be photographed or videotaped. If you aren't comfortable with your image being used, please inform us by email (aholisticheart@yahoo.com). By signing this agreement, you agree to these terms.
Hold Harmless Clause
- Except in the case of gross negligence or malpractice, I or my representative(s) agree to fully release and hold harmless Lynn Gantner (DBA, Holistic Heart Breathwork) from and against any and all claims or liability of whatsoever kind or nature arising out of, or in connection with my session(s).
Modification of Agreement
- Any amendment or modification of this Agreement or additional obligation assumed by either Party in connection with this Agreement will only be binding if evidenced in writing signed by each Party or an authorized representative of each Party.
Enurement
- This Agreement will enure to the benefit of and be binding on the Parties and their respective heirs, executors, administrators and permitted successors and assigns.
Governing Law
- This Agreement will be governed by and construed in accordance with the laws of the State of California
Severability
- In the event that any of the provisions of this Agreement are held to be invalid or unenforceable in whole or in part, all other provisions will nevertheless continue to be valid and enforceable with the invalid or unenforceable parts severed from the remainder of this Agreement.
Waiver
- The waiver by either Party of a breach, default, delay or omission of any of the provisions of this Agreement by the other Party will not be construed as a waiver of any subsequent breach of the same or other provisions.
To submit questions regarding this release, please email: aholisticheart@yahoo.com
