Name *

First Name

Last Name

Waiver/Release of Liability: *

On behalf of myself, my estate and the personal representative thereof, my heirs and assigns, I hereby forever release, hold harmless, defend and indemnify Grounded and Calm and their officers, directors, employees and agents, from any and all costs, claims, losses, liabilities or damages arising from or in any way related to, my participation in Grounded & Calm LLC classes. I intend this release and indemnity to be regardless whether the claim of liability is asserted in negligence, strict liability in tort, or other theory of recovery. For myself, my estate and the personal representative thereof, my heirs and assigns, I covenant and agree to make no claim, nor to institute any suit, action or proceeding against either Grounded & Calm LLC and their officers, directors, employees and agents, relating to any accident, incident or occurrence arising out of, or in connection with, my participation in Grounded & Calm LLC classes. In agreeing to this release, I have fully informed myself of the content of this release and I have reviewed it and understand what it means, and this release is signed as my own free act and deed. *While meditation is generally considered safe and beneficial, there is a small risk that it may trigger seizures in individuals with a history of epilepsy or other seizure disorders. By participating, you acknowledge this risk and agree to assume full responsibility for your well-being during meditation sessions. I do hereby certify that I am capable of participating in the program.

I Agree