TEMPLE DAY

RELEASE AND WAIVER OF LIABILITY AGREEMENT

In consideration of being permitted to participate in one or more Women’s BodyMystik Dance Circles and/or Ceremonies or Temple Day (the “Workshops”), I agree to the following:

  • I acknowledge that there is physical activity involved in the Workshops, and therefore some risk of physical injury.  I agree to participate with full knowledge of these risks.  Should I deem my participation in any of the activities to be unsafe, I will opt out of that particular process and not put myself in harm’s way.  I further agree that it is my sole responsibility to make this judgment call, and not the responsibility of the Workshop facilitator(s) nor any of the other participants.

  • I understand that the Workshops are not therapy or psychological counseling and that Heather Munro Pierce Kelley is not a licensed therapist.  If I desire therapy or psychological counseling, I will seek it from a licensed provider.  I affirm that I am in good emotional and psychological health.  If I am under the care of a mental health professional, I have consulted with and obtained permission to participate in the Workshops from that mental health professional.

  • I assume all risk from participating in the Workshops.  I and my heirs and assignees hereby release Heather Munro Pierce Kelley, Temple Arts Institute LLC, Hillside Community Church, Lowell Brook and Loren Eskenazi as well as their owners, teachers, officers, agents, contractors and employees, from any liability claims, demands and causes of action, now or in the future, for any losses or physical, emotional or psychological illness or injury, however caused, arising from, occurring during or occurring after my participation in the Workshops.

  • I further expressly agree that this release, waiver of liability and indemnity agreement is intended to be as broad and inclusive as is permitted by the law of the state of California, and if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

  • I have read and voluntarily signed this document, and further agree that no oral representations, statements or inducements apart from the foregoing written agreement have been made.

This release and waiver of liability agreement is governed by the laws of the State of California, United States of America.


Signee Information

By clicking 'I Agree' below, you agree that you have read and agree with the terms of the waiver and that the information you provided is accurate. You furthermore agree that your submission of this form, via the 'I Agree' button, shall constitute the execution of this document in exactly the same manner as if you had signed, by hand, a paper version of this agreement.