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Metaphysical Wellness Center
& Supply Store
Route 59, West Chicago, IL
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The Journey's Path Liability Waiver
First & Last Name of Participant
Email
Phone
The person recieving services is 18 or older
Guardian's Full Name
Please specify anything we should know about.
I hereby acknowledge this release from liability for accidental injury or illness, i which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in physical activity or a touch therapy.
I voluntarily request and consent to receive services for my child, my pet or myself from staff & contractors of The Journey’s Path. I understand that I must be present at all times when my child or pet are receiving treatment. I understand and acknowledge that no guarantees have been made as to the effect of such services. I further understand that there are no guarantees as to the safety of participating in such services due to the socially known risks of Covid-19 and take all responsibility of risk upon myself. I further assert that I am not feeling sick, nor have I nor anyone in my household had known symptoms of Covid-19 within the last 14 days or have tested positive for the virus. I understand the practitioner may require me to wear a mask during the service / treatment. I further understand and acknowledge that in no way are these services meant to be construed by me as the diagnosis or treatment of disease, but rather as an aid to balancing my energy and possibly improving my general wellness. I understand that prior to the first session, I will receive an oral explanation and description of what the Practitioner(s), Reader(s) or Consultant(s) do in the session. I understand that I may refuse any and all services at any time during my first session or during any subsequent sessions. I understand that Practitioners, Readers & Consultants from The Journey’s Path uphold the highest standards of care and professionalism. I understand that therapeutic services provided are intended to enhance relaxation and aid in stress reduction. I understand that these services are not a substitute for medical treatment or medications, and it is recommended that I concurrently work with my physician or primary caregiver for any condition that I, my child or my pet may have. I am advised that if I, my child or or my pet are ill or have any serious health issues, I should consult my physician, veterinarian or health care practitioners. I am aware that The Journey’s Path Practitioners, Readers & Consultants do not diagnose illness or disease and do not prescribe medication. If I or my pet experience any discomfort during the session, I will immediately communicate that to the Practitioner, Reader or Consultant so that the treatment can be modified or ended.
Guardian: Type your full name below to consent
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