Intikhana Ceremonies and Retreats
Release of Liability

I have completed a Confidential Participant Information Form and have accurately and fully represented my medical condition, prescription drug use, recreational drug and alcohol use, and have fully disclosed my physical and psychiatric condition. I have no medical, physical, or psychological conditions that would endanger myself or any other participants in the Ceremony.

I certify that I have not taken any form of anti-depressant medication, antibiotics, or sleeping pills for at least seven (7) days previous to the day of the Ceremony. I have not decided to stop the use of prescribed medication in order to participate in the Ceremony without consulting my physician.

I have read the information sheet provided by the organizers and will follow the guidelines as closely as possible. I am aware that there is no obligation for any person to provide me with medical care during the Ceremony. I accept full responsibility for any risks associated with participation in the Ceremony. I accept full responsibility for any costs of any medical attention or services that I may need. 

I agree to stay for the duration of the Ceremony and will not leave the premises until instructed by Ceremony staff that it is permissible to do so. I take full responsibility for transportation to and from the Ceremony. I hereby acknowledge that I if I am required to use an automobile to travel to and from the Ceremony that I will not drive until Ceremony staff permits me to leave the premises. I accept full responsibility for the automobile, and the use of the automobile will be at my own risk.

I understand that spiritual healing is not a substitute for medical or psychiatric advice and treatment but can be a part of a well- rounded, holistic approach to healthy living. I understand that the organizers and staff are not licensed in the medical field, they do not diagnose or prescribe any medications for any conditions, nor do they diagnose, treat, or cure any medical conditions.

I understand and agree to abide by the zero tolerance policies prohibiting sexual, emotional, physical harassment or violence, and racism, sexism, xenophobia, and other forms of discrimination.

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY (reimburse for any loss including any reasonable legal fees they may incur), AND HOLD HARMLESS THE CEREMONY STAFF, their officers, officials, agents and/or employees, other participants, and, if applicable, owners and leasers of premises used for the Ceremony (“RELEASED PARTIES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES OR OTHERWISE, to the full extent permitted by law. I KNOWINGLY AND FREELY ASSUME ALL RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES or others, and assume full responsibility for my participation; and

I hereby understand, acknowledge and voluntarily assume all risks involved in my participation with this ceremony session. I release, and agree to hold harmless the facilitators, organizers, hosts, the location and all participants of any and all liability and/or expenses due to personal accident, injury or death, medical cost, reparation cost, losses, and any and all other expenses and responsibilities which may arise during or after the session. I understand I am participating in a non-commercial, non-recreational activity and assume full responsibility for my participation in any and all activities associated in this session. I understand and agree to observe and have followed the preparation instructions provided by my facilitator. This includes dietary preparation and full disclosure of all drugs and/or prescription medications I am currently taking or have taken recently, as well as full disclosure of all health and heart conditions as indicated in the health questionnaire.

I hereby state that to the best of my knowledge, I do not have any existing heart conditions or complications. I have not had heart surgery or had organs removed, and I do not have high or low blood pressure. I am not on chemotherapy, taking medication for blood pressure, and I do not have Addison's disease. I am not pregnant. I am not currently taking prescription medications that have not been disclosed with the practitioner. I believe myself to be in good physical and psychological condition to sit in ceremony.

I am signing this agreement and I agree to accept  full responsibility for my health and safety as well personal effects and actions during ceremony. I also fully agree to follow the advice and guidelines of the facilitators during and post the session. I further agree to defend and indemnify the facilitators and participants as well as location or hosts of any suits, claims, or demands.

My checkbox accepting this agreement upon offering checkout indicates that I have read and understand everything contained in this waiver and release form. I agree not to bring forth any lawsuit for damages regardless of whether or not negligence can be demonstrated and agree to release any parties associated with the facilitation of the session. I understand that this agreement is binding upon me, my spouse, parents, family, heirs, executions, administrators, agents, and assigns.
I understand agree that each and every provision of this agreement is independent of any other provision and may be enforced even if other provisions are not enforceable.