Waiver Form | The Way Of The Heart

Liability Waiver & Release Form

Please complete before attending your first session.

First name

Last name

Date of Birth

Initials

I declare that the info I’ve provided is accurate & complete

I understand that products and services offered by The Way of the Hearts Energy Centre (TWHEC) support the body, mind, and soul's natural ability to create wellness in my life. I understand that (TWHEC) practitioners do not diagnose conditions, nor do they prescribe or perform medical treatment, prescribe substances, nor interfere with the treatment of a licensed medical professional. I understand that energy healing, or any service provided by (TWHEC) does not take the place of medical care. It is recommended that I see a licensed physician or licensed healthcare professional for any physiological or psychological ailment I may have. I understand that energy healing provided by (TWHEC) can complement any medical or psychological care I may be receiving. I also understand that the body has the ability to heal itself and to do so, complete relaxation is often beneficial. I acknowledge that long term imbalances in the body sometimes require multiple sessions in order to facilitate the level of relaxation needed by the body to heal itself. (TWHEC) is not liable for my medical, mental, or emotional conditions before, during, or following any service provided by (TWHEC). I take personal responsibility for my well-being and with respect for myself I gratefully accept control of my choices. My heirs, guardians, legal representatives, and I hereby and forever release, waive, and discharge any claims against, (TWHEC), and/or any of their associates or affiliates. I take full responsibility and am responsible for all liability for loss or injury incurred while in association with (TWHEC) and/or any of their associates or affiliates. I have carefully read this agreement and fully understand its content. I am aware that this is a waiver and release of potential liability and a contract between the above noted parties and myself. I understand that this contract is binding and acknowledge that I am signing this of my own free will.

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The Way of the Hearts Energy Centre

Liability Waiver & Release Form

Please complete before attending your first session.

Click here to
print a copy of the waiver

Haga clic aquí para imprimir una versión en español de la exención.

Liability Waiver & Release Form

Please complete before attending your first session.

Click here to print a copy of the waiver

Haga clic aquí para imprimir una versión en español de la exención.

Click here to
print a copy of the waiver