Waiver, Release, and Assumption of Risk Form

This form is an important legal document. It explains the assumption of any and all risks in deciding to follow the advice or insight from Energy Healer Tinesha Keith, who operates as an advising consultant through LifeUnBlocka, or a representative of that Company. It is critical that you read and understand it completely.

Waiver, Informed Consent, and Covenant Not to Sue

I hereby acknowledge that I have volunteered to participate in a paid or unpaid session, workshop, or program with Tinesha Keith and/or an advisor available through LifeUnBlocka., to include, but also may not be limited to, any and all services provided, such as energy healing, intuitive coaching, and workshop attendance.

In consideration of the LifeUnBlocka agreement to instruct, assist, advise, or train me, I do here and forever release and discharge and hereby hold harmless the Company and its respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in a session or purchase or any program WITHOUT LIMITATION, WHICH MAY OCCUR AS A RESULT OF following advice tendered and released or training rendered or use of facilities during a session or event.

We recognize that in no way does any member of LifeUnBlocka provide legal, medical, or therapeutic advice and it is my responsibility to secure such advisement.

I acknowledge and agree that I assume the risks associated with any and all activities and/or programs in which I participate.

I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from any insight or program. I understand that results are individual and may vary.

I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, VISITING THIS WEBSITE, READING THIS DOCUMENT, or USING SERVICES, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST LIFEUNBLOCKA FOR YOUR NEGLIGENCE OR THAT OF YOUR EMPLOYEES, AGENTS, REPRESENTATIVES, OR CONTRACTORS.

Privacy Notice:

No information about any client will be discussed or shared with any third party without the written consent of the client or parent/guardian if the client is under 18