Fill and Sign the Waiver and Release from Liability for Reiki Treatment 497329011 Form

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Waiver and Release from Liability for Reiki Treatment Whereas, ___________________ (Company) provides the service of Reiki which involves a gentle massage therapy for deep relaxation in an attempt to provide beneficial effects by strengthening and normalizing certain vital energy fields within the body; and Whereas, the undersigned ______________________ ( Customer ) desires to use the said services of Company ; Now, therefore, for and in consideration of using said Reiki services offered by Company , and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the undersigned Customer does hereby waive and release, indemnify, hold harmless and forever Company, and its agents, employees, officers, directors, affiliates, successors and assigns, of and from any and all claims, demands, debts, contracts, expenses, causes of action, lawsuits, damages and liabilities, of every kind and nature, whether known or unknown, in law or equity, that I ever had or may have, arising from or in any way related to the services being provided to me by Company, provided, however, that this waiver of liability does not apply to any acts of gross negligence, or intentional, willful or wanton misconduct. By this Waiver, I assume any risk, and take full responsibility and waive any claims of personal injury, death or damage to personal property associated with such services by Company. This Waiver and Release contains the entire agreement between Company and myself, and supersedes any prior written or oral agreements concerning the subject matter of this Waiver and Release. The provisions of this Waiver and Release may not be waived, altered, amended or repealed, in whole or in part, without the prior written consent of Company and myself. The provision of this Waiver and Release will continue in full force and effect even after the termination of the services being provided to me, whether by agreement, by operation of law, or otherwise. I have read, understand and fully agree to the terms of this Waiver and Release. I understand and confirm that by signing this Waiver and Release I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional Waiver and Release of all liability to the full extent of the law. I am 18 year of age or older and mentally competent to enter into this Waiver and Release. WITNESS my signature this the day of , 20 . ___________________________ CUSTOMER

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