I hereby acknowledge that I voluntarily agree to attend and/ or participate in a paid or unpaid session, class, course, workshop, retreat, program or other service with Amanda L. Bilby, (hereafter referred to as “my coach”) or any other coach that works for the following Shamanic Quantum Healing/ Sage Rainbow Sanctuary of NACTI.
I understand and agree that the information and all services provided such as, but not limited to, coaching, education, guidance, energy healing, product offerings, classes, courses, retreat and workshops, by my coach, Shamanic Quantum Healing/ Sage Rainbow Sanctuary of NACTI. or any information set forth on the website and or page Shamanic Quantum Healing/ Sage Rainbow Sanctuary of NACTI. is to be used for educational and entertainment purposes only and does not constitute legal or professional advice, neither is it intended to be.
I understand and agree to disclosed all relevant information regarding my physical, emotional and/or mental conditions that could cause harm to me, the client, by participating in any of these coaching and educational services. I understand and agree that Amanda L. Bilby or any other coach for Shamanic Quantum Healing/ Sage Rainbow Sanctuary of NACTI. is not acting as a mental health counselor or a medical professional in any capacity in these services. I understand and agree that the coaching and educational services that I receive from my coach or Shamanic Quantum Healing/ Sage Rainbow Sanctuary of NACTI.are not offered as a substitute for professional mental health care or medical health care and are not intended to diagnose, treat or cure any mental health or other medical conditions and I will not use it in place of any form of such therapies.
I recognize and agree that coaching and educational services may require emotional, physical, and mental efforts, exertion, and behavioral experimentation on my part, which may cause physical, mental or emotional injury, and I fully acknowledge and agree to take full responsibility for any risks involved. I understand and agree that I am fully responsible for my well-being during my coaching and educational services sessions or my attendance or participation in any classes, workshops, or other programs, and subsequently, including my choices and decisions.
I understand and agree that coaching is, at present, an unregulated industry and that my Coach is not licensed by any state.
I understand and agree that for all legal purposes, all the coaching and educational services provided by my Coach will be considered to be provided in the many different states and other countries.
I understand that life coaching, retreats and educational services are provided "as is”, without warranty of any kind, either expressed or implied. I understand and agree that my coach is not promising outcomes included but not limited to increased clientele, profitability and or business success. I understand and agree that all comments, ideas and suggestions offered by my coach are my coach’s opinions that are expressed solely for the purpose of aiding me in educating me towards achieving my goals.
Confidentiality:
I understand that my coach will protect my information as confidential unless I state otherwise in writing. I understand and agree that the use of technology is not always secure and I accept the risks of confidentiality in the use of email, text, phone, FaceTime/Facebook Live, Skype, Zoom and other technology. If I report child, elder abuse or neglect, or threaten to harm myself or someone else, I understand that necessary actions will be taken and my confidentiality agreement limited in this capacity. Furthermore, if my coach is ordered by a court to provide information or to testify, she will do so to the extent the law requires.
I hereby release, waive, acquit and forever discharge my coach and Shamanic Quantum Healing/ Sage Rainbow Sanctuary of NACTI., any agents, successors, assigns, personal representatives, executors, heirs and employees from every claim, suit action, demand or right to compensation for damages I may claim to have or that I may have arising out of acts or omissions by myself or by my coach as a result of the educational information and advice given by my coach or otherwise resulting from the coaching relationship contemplated by this agreement. This agreement shall bind my heirs, executors, personal representatives, successors, assigns, and agents.
I further declare and represent that no promise, inducement or agreement not expressed in this agreement has been made to me to sign this agreement.
I have the legal ability to give my informed consent, and hereby give such consent to my coach to educate and assist me towards achieving my goals.
I, the client, understand and agree that by filling out my contact information below and submitting this form, that I have reviewed, understand and agree to each of the statements and the terms and conditions stated above that I am requesting coaching and educational services from Amanda Bilby, NACTI of Sage RAinbow Warriors. I'm giving my consent if im not a member already to become a member for the day so I may participate in a Traditional Plant Medicine Ceremony/ies i will be present and participating through Sage Rainbow Sanctuary of NACTI.
*No information about any client will be discussed or shared with any third party without written consent of the client or parent/guardian if the client is under 18.