Shadow Guide Immersion Waiver
Welcome! We are excited you are able to join us for the Shadow Guide Immersion Experience facilitated by Keri Nola and guest facilitators. We are looking forward to offering you a variety of activities throughout the Experience.
We request that you participate in only those activities that you are physically, mentally, emotionally, and spiritually able to do, and that you notify us of any restrictions you have regarding any of the activities, and we will do our best to accommodate them. Your safety and comfort is of the utmost importance to us.
Please read the following information carefully and let us know if you have any questions before signing and agreeing to this.
Registration payment is non-refundable and possibly transferrable in special circumstances as determined on a case by case basis.
We reserve the right to decline attendance and refund registration fee to any individual we deem an inappropriate fit for this experience.
RELEASE AND WAIVER
I voluntarily desire to participate in the Shadow Guide Immersion Experience (“Experience”) organized by Keri Nola of Path to Growth, LLC (the “Facilitator”). I understand that the Experience will involve an in-person, live educational and healing experience, including possible pre-event and post-event coaching/mentoring/intuitive sessions via phone or video, and Facebook group interactions, for the purposes of facilitating personal/professional growth, healing and transformation experiences using holistic methods. In exchange for participation in the Experience and/or use of the property, facilities, meals and services provided during the Experience, I agree to the following:
I take full and sole responsibility for my life, business, well-being and all decisions made before, during and after the Experience.
I acknowledge that I am choosing to participate voluntarily in various activities at the Experience and I recognize that these activities may contain certain inherent risks. These activities may include, but are not limited to: arts and crafts (creativity), group discussions, meditation, breathing exercises, guided imagery, spiritual work, journaling, nature activities, beach visits, swimming, meditative walks, physical activities, aromatherapy, energy work, massage, body work, chiropractic care, appropriate physical contact for the purposes of facilitating healing, intuitive readings, and other activities provided by the Facilitator/s, Event Sponsors, or others (collectively “Program Activities”).
I expressly assume the risks of the Experience and all Program Activities. I understand that I am responsible for my own transportation to/from the Experience, including any transportation during the Experience, and that all transportation is at my own risk and liability, even if the Facilitators provide suggestions, recommendations, discounts or offers related to transportation, hotels, and/or other accommodations.
I agree to observe and obey all posted and announced rules and warnings, and further agree to follow any instructions or directions given by the Facilitators, or their employees, representatives or agents. Specifically, I agree to refrain from consuming any alcohol or drugs of any kind during the duration of the Experience at any time, unless prescribed by a medical or mental health practitioner and consumed appropriately in accordance with the prescription dosage.
I understand that the information provided at or in conjunction with the Program Activities and Experience is not intended to be a substitute for professional medical advice, diagnosis or treatment that can be provided by my own physician, therapist, licensed dietitian or nutritionist, or any other licensed or registered mental or physical health care professional. I understand that the Facilitator/s and their employees, representatives and agents are not acting in any capacity as a medical or mental health care provider, unless you are currently in an established therapeutic relationship with Keri Nola which is bound by informed consent. I understand that they are not providing health care, medical or nutrition therapy services or attempting to diagnose, treat or cure in any manner whatsoever any disease, condition or other physical or mental ailment of the human body during the course of the Retreat. Rather, they are serving in their capacities as Facilitators, coaches, mentors and guides, unless you are currently in an established therapeutic relationship with Keri Nola which is bound by informed consent.
I understand that I may be provided with meals, snacks, and other products or services provided by or through the Facilitators, Event Sponsors or others while at the Experience and I agree to disclose to the Facilitators in advance any known or suspected food allergies or sensitivities, any physical limitations that may impact my breathing or movement, or any other health or mental condition that may be affected during the Experience. If I suspect that I have a medical or mental health problem, I agree to inform the Facilitators and their agents immediately.
I agree to seek the advice of my physician or another qualified health care professional prior to and during the Experience regarding any questions or concerns I have about my specific health situation, possible or actual pregnancy, known or suspected food sensitivities or allergies, dietary restrictions, or any medications I am currently taking. I understand that I am advised to speak with my own physician or mental health provider before attending the Experience or implementing any Program Activities. I agree to not disregard or delay seeking professional medical advice or stop taking any medications without speaking to my own physician or mental health care professional.
At any time before or during the Experience, should I know or feel that I may cause imminent harm to myself, other participants, the Facilitators, or any other person, I understand and agree that I am immediately obligated to let the Facilitators know, and to remove myself from the situation in a peaceful and cooperative manner; otherwise, I consent that I may be asked to not attend the Experience, leave the Experience, and/or have immediate physical or mental health care administered to avoid causing mental or physical harm to myself or others.
I consent to the application of first-aid or other medical or mental health services to be applied if needed in connection with an emergency health problem or potentially harmful situation during the Experience, and I agree to hold the Facilitators harmless as a result of any such injury or damage I may suffer due to the application of medical or mental health services or treatment. I also agree and consent that the Facilitators may contact my Emergency Contact as shown on the bottom of this form if they deem it necessary.
I release the Facilitators and Event Sponsors from any and all liability, damages, causes of action, allegations, suits, sums of money, claims and demands whatsoever, in law or equity, which I have ever had, now have or will have in the future against the Facilitators or Event Sponsors, arising from my past or future participation in, or otherwise with respect to, anything related to and including the Experience, including transportation to, from and during the Experience, unless arising from the gross negligence of the Facilitators.
In no event will the Facilitators or Event Sponsors be liable to any party for any direct, indirect, special, incidental or consequential damages for any use of, non-use, or reliance on this Experience, its information, programs, meals/snacks/food, products and/or services, including, without limitation, personal injuries, accidents, misapplication of information, or any other loss, malady, disease or difficulty, or otherwise, even if I am expressly advised of the possibility of such damages or difficulties, whether caused by the fault of myself, the Facilitators, Event Sponsors, other attendees or other third parties. I agree to pay for all damages to the facilities caused by any negligent, reckless, or willful action that I may take.
By participating in this Experience, I consent to photographs, videos, and/or audio recordings that may be made that may contain me, my voice and/or my likeness. I understand that I release all rights and you reserve full rights to use these photographs, videos, and or/audio recordings and/or any other materials submitted by me to you in connection with my participation in the Experience in any way related to your business and/or your current or future marketing or promotional efforts, without compensation to me at any time, now or at any time in the future.
Any dispute concerning this release, the Facilitators or any aspect of my participation in the Experience or Program Activities shall be governed by the laws of the State of Florida and brought in the state or federal courts of Florida.
I have carefully read this document and by checking the agreement box I consent to all parts of it. I understand that by checking the agreement box, I voluntarily surrender certain legal rights.
EMERGENCY CONTACT INFORMATION
In case of an emergency, I authorize Path To Growth, LLC and its agents to contact by phone, text, and/or e-mail the emergency contact I provided on my registration form.