I. Acknowledgement of Request for Healing

I understand that submitting this form and donation does not guarantee that the person healing is requested for will receive an individual session, but that they may be included in group energy work*

II. Description of Services

I acknowledge that I have voluntarily requested and consented to receive energy healing services from EC HEALING LLC, (including their employees, agents, or volunteers) which may include various forms of energy work, such as Reiki, Transference Healing, chakra balancing, or other similar modalities.*

III. Acknowledgment of Risks

I understand and acknowledge that energy healing involves holistic practices that are complementary to conventional medicine but are not a substitute for licensed medical or psychological care. I recognize that there are inherent and potential risks associated with energy healing, including but not limited to:

• Emotional or psychological discomfort

• Intensification of existing emotions

• Physical sensations or discomfort

• Release of stored emotions

*

IV. Release of Liability

In consideration of receiving energy healing services from EC HEALING LLC, I hereby release, waive, discharge, and covenant not to sue EC HEALING LLC, their employees, agents, or volunteers from any liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or to any property belonging to me arising out of, or related to, the energy healing services provided.*

V. Assumption of Risk

I acknowledge that I am voluntarily participating in energy healing sessions with full awareness of the potential risks involved. I understand that I am not engaging in these services blindly and that I accept responsibility for any outcomes that may arise. This includes, but is not limited to, loss of property, personal injury, or, in extreme circumstances, death. By choosing to receive these energy healing services, I knowingly and willingly assume all associated risks.*

VI. Indemnification

I agree to compensate for any loss, assume responsibility for any liability or damage, and cover any costs, including court expenses and attorney’s fees, arising directly or indirectly from my participation in energy healing services provided by EC HEALING LLC. I further agree to indemnify and hold harmless EC HEALING LLC, including its owners, members, employees, agents, contractors, and volunteers, from any claims, liabilities, damages, or expenses related to such services.*

VII. Informed Consent

I am putting my signature on this Energy Healing Waiver Release of Liability document as an explicit confirmation that I have an adequate understanding about the nature of the energy healing services that I am about to receive. I understand that it may be individual or it may be group work, but it is not guaranteed. I understand I may not be notified of any energy work that has been completed.*

VIII. Legal Age and Authority

I hereby solemnly affirm and declare that I have reached the legally acceptable age that renders me competent to provide an official signature on this waiver. Should this signature be required on behalf of an individual who is a minor or an individual who is incapable of providing their consent, I stand firm in my affirmation that I carry the legally mandated authority to execute such an action.*

IX. Agreement

I affirm that I have personally reviewed and fully understand every term in this Energy Healing Waiver and Release of Liability. I acknowledge that my decision to sign this document is made independently, freely, and voluntarily, without coercion. I intend to be legally bound by its terms and conditions, fully recognizing that my signature constitutes acceptance and affirmation of all stated provisions.*