Release and Liability Waiver

Jennifer Heine Evolving Star Spirit

www.evolvingstarspirit.com, info@evolvingstarspirit.com

Acknowledgment and Release of Liability Form

PLEASE READ CAREFULLY. You have agreed to the following when you sign this form in order to participate in a workshop, session, coaching or any services offered by Jennifer Heine Evolving Star Spirit. Your digital document signature or manual signature is required in order to participate in any services rendered by Jennifer Heine Evolving Star Spirit.

I understand in registering and providing payment I am expressing desire to receive instruction, coaching, teachings, meditations, physical postures and suggested nutrition and exercises e.g. eating behaviors, diets, biking, hiking, walking, running or use of health or fitness equipment that could be potentially hazardous. The level of my participation in any Jennifer (or alias Jen) Heine Evolving Star Spirit Sessions, Classes Workshops In Person or Online is determined by me, therefore, I am representing and warranting to be healthy and able to perform all exercises, breathing and meditation without risk of medical injury or impairment.

I understand that I cannot participate in this program if I have any type of bipolar disorder, under the age of 18, and do not have any medical condition including kidney dialysis, blood cancer or active drug or alcohol addiction and by signing this form I am stating that I am over the age of 18 and do not have the above conditions. I understand that my body movements are my responsibility.

I understand that Jennifer Heine, in making these personal sessions, classes, workshops available, is not undertaking any responsibility regarding my medical condition(s). If my medical condition should change, I understand that it is my responsibility to discontinue the program and to immediately consult with my physician about continuing or resuming participation in this program.

I hereby release, indemnify and hold harmless Jennifer Heine, her members of this class or workshop from any and all claims, demands, personal injuries, costs or expenses arising out of my participation in this program. I understand the nature and extent of the teachings and exercises in which I am participating and that while implementing teachings or performing these exercises, I could sustain bodily injury.

All right to the methods, teachings, coaching and all materials provided and taught to me by Jennifer Heine are reserved. I understand that no video, cell phone recording, or photography is allowed. No part of the methods, teachings, coaching and all materials provided may be reproduced in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without a written permission from Jennifer Heine.

I understand that I would not be accepted in this program without the execution of this Release. I have read this Release and been given the opportunity to ask any questions. I have received and understand the information provided.

This acknowledgment and release attests that I have carefully read and acceptance the above terms.

Legal Name, Print Clearly Email

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Signature Date

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NO RECORDING, NO VIDEO OR CELL PHONE RECORDING, NO PHOTOGRAPHY

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