Please Initial* I understand that Olivia Halliday has been trained in traditional and holistic/indigenous practices by medicine men, medicine women, reiki masters, as well as her own inherent gifts as a clairvoyant.
Please Initial* I understand that I am entering into non-traditional therapeutic work with Olivia Halliday which includes but is not limited to; energy work, mediumship, intuitive support and coaching, ceremony, bodywork, apprenticeship, and education.
Please Initial* I understand that during some portions of energy work physical touch for grounding and comfort may be necessary or desired by me, as the client. Should that be the case I understand it is not a substitute for proper medical consultation for physical, mental and psychological illnesses and may not be suitable for everyone. It is contra-indicated for people suffering from major psychiatric disorders. If in doubt I will consult a trained medical professional for guidance or additional support.
Please Initial* I understand Olivia Halliday declines any responsibility for incidents resulting from my energy work session. By taking part in an energy work session I accept full responsibility for my physical and mental fitness and state. I affirm I am able to participate safely in the activity.
Please Initial* I understand I must tell Olivia if I feel emotionally or physically uncomfortable or concerned at any time throughout the session.
Please Initial*I understand no alcohol or illegal drugs are allowed during my scheduled session time.
Please Initial*I understand I must disclose any additional doctors or therapists for any emotional issues or if I am taking medication for any emotional disorder prior to our session.
Please Initial*I understand any physical contact during sessions are NOT to be interpreted as sexual. All touching, both given and received, will be conducted in a professional and nonsexual manner. Touching is limited to areas which would not normally be covered by a swimsuit, both parties will remain fully clothed.
Please Initial*I understand that should any of my actions be interpreted as inappropriate or a risk to personal safety, Olivia Halliday reserves the right to terminate the session immediately with no warning or refund given.
Please Initial*I understand that the movement of energy can show up in many different ways including but not limited to; tears, anger, laughter etc. All are possible during the session and all are normal and welcome.
Please Initial*I understand that if a refund is granted for any reason all processing fees incurred will be my responsibility.
Please Initial* I understand that all payments processed prior to notifying Olivia of my intent to cancel or pause my membership are non-refundable.
Please Initial* I commit to communicating with Olivia via email if I am dissatisfied or seeking a change in my membership.
Please Initial* I commit to leaving room for curiosity, being open, and trust the process; not comparing my journey to anyone else around me.
Please Initial* I hereby waive all claims for injury or loss to person or property during participation in sessions, classes, workshops or other activities. My participation is voluntary and at my own risk.
Please Initial* I hereby release respective owners, instructors, and assigns from any liability claims, demands, injuries, actions, or causes of actions to my person or property arising out of or connected with the use of any of the services, equipment, or facilities provided.
Please Initial* Further, I confirm that I either have specific insurance to cover any injuries that I may sustain or that I have chosen to participate in these activities without any insurance coverage and agree to assume full responsibility of any and all risks, known and unknown, bodily injury, death and property damage which may arise from my decision to participate sessions, classes, workshops, and other activities.
Please Initial* I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.
Please Initial* I acknowledge that engaging in-person through sessions/workshops/teachings is at my own risk and it is entirely up to my comfort level should I choose to participate as virtual offerings are also available.
Please Initial* I further acknowledge that Olivia cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others.
Please Initial* I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
Please Initial* If a patient threatens to harm himself/herself, I may be obligated to seek hospitalization for him/her, or to contact family members or others who can help provide protection.
Please Initial* If I have reason to believe that a child under 18 who we have examined is or has been the victim of injury, sexual abuse, neglect or deprivation of necessary medical treatment, the law requires that I file a report with the appropriate government agency, usually the Office of Child Protective Services and the local police department. Once such a report is filed, I may be required to provide additional information.
Please Initial* If I have reason to believe that any adult patient who is either vulnerable and/or incapacitated and who has been the victim of abuse, neglect or financial exploitation, the law requires that I file a report with the appropriate state official, usually a protective services worker. Once such a report is filed, I may be required to provide additional information.
Please Initial* If a patient communicates an explicit threat of imminent serious physical harm to a clearly identified or identifiable victim, and I believe that the patient has the intent and ability to carry out such threat, we must take protective actions that may include notifying the potential victim, contacting the police, or seeking hospitalization for the patient.
I have carefully read with a full, definite and clear understanding of the foregoing provisions and freely enter into the within agreement of the Contract, Waiver and Indemnification Form.
Please Initial*I understand that if my payment fails or there is an issue with my auto-payment the secondary form of payment will be used. If the secondary form also fails I will be issued an invoice and am responsible for reconciliation of the outstanding balance.