Shamanic Living Center Waiver And Release Form (Page 2 of 4) in pdf

Shamanic Living Center Waiver And Release Form Page 2

Shamanic Living Center

Waiver and Release Form

Page 2

This Waiver and Release Agreement will be construed in accordance with and

governed by the laws of the State of California, and it is acknowledged by the Releasor

to be as broad and inclusive as permitted by the laws of this jurisdiction.

I HAVE READ AND UNDERSTAND THIS AGREEMENT AS WELL AS THE

SWEATLODGE INFORMATION SHEET, AND I AM AWARE THAT BY SIGNING THIS

AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS,

NEXT OF KIN, EXECTUROS, ADMINISTRATORS AND ASSIGNS MAY HAVE

AGAINST THE RELEASEE(S).

The Releasor has executed this Waiver and Release at Somerset, El Dorado County,

California on the __________________ (date).

SIGNED, SEALED AND DELIVERED

In the presence of

WTINESS:

RELEASEOR

CALL IN CASE OF EMERGENCY

DOCTOR’S NAME & PHONE NUMBER

Any physical limitations, medical ailments, physical or mental disabilities? Please list

here after speaking to the Releasee.

______________________________________________________________________

Shamanic Living Center Waiver And Release Form Page 2