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repealed, in whole or in part, without the prior written consent of Company and myself.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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