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

Shamanic Living Center

Waiver and Release Form

Page 2

exiting the lodge. When someone is entering or exiting draw your body parts back from the path

around the pit so you will not be stepped on and they will not trip over you.

When the last round is over everyone in the lodge calls “Fire Keeper, All My Relations.”

All exit the lodge and sit or stand around the fire. A closing prayer is said and the sweat is

called complete. You may then claim your belongings and exit the circle at the entrance and go

get dressed. It is important that you eat and drink before you attempt to drive home. Please be

sure you are in body, not dizzy or disoriented, before leaving. Be sure to replenish your body

over the next day by drinking plenty of water and/or juices.

The sweatlodge ceremony has some potential risks that you must familiarize yourself

with before choosing to participate. There is an open fire that you must walk around and could

burn yourself on. There is a pit within the lodge with hot rocks that you could step or trip into

and burn yourself. The heat of the lodge may cause dizziness or disorientation, making falls of

burns from hot rocks a risk. The humid heat may irritate the following conditions: skin lesions

or rashes (especially poison oak), heart conditions, hypoglycemia, diabetes and high blood

pressure. The effects and risks of the sweatlodge conditions on pregnancy are not known;

pregnant women should be aware that the sweatlodge may or may not be detrimental. The

experiences of releasing or vision may elicit strong emotional or physical reactions. The

cramped, closed, dark conditions within the lodge may trigger claustrophobic reactions such as

panic or anxiety attacks and have caused occasional deaths of the participants.

The people operating the sweatlodge are not licensed or certified and make no such

claims. They are here to offer their experience to support your personal work in the sweatlodge.

They accept no responsibility for your growth or healing and make no promises of such.

I have read the above information and statements of fact regarding the sweatlodge ceremony. I

am aware that the people of the Shamanic Living Center are not licensed or certified and are not

responsible for my growth or healing and make no promise of help or release from any emotional

or physical dysfunction. I understand and accept the risks stated above and assume full

responsibility for the consequences of my decision to participate. I agree not to hold the

Shamanic Living Center responsible for any incident or dysfunction that may result from my

participation in the sweatlodge ceremony. I hereby authorize the Shamanic Living Center to

obtain medical care for me in case of an emergency.

Participant’s name (printed)

Participant’s signature

Date

Suggested Sweat donation $20.00

Shamanic Living Center Waiver And Release Form Page 4