VITAL KI INC. PRIMAL CONSCIOUSNESS PROGRAM
Intake, Informed Consent & Liability Waiver
Facilitator: Angela Tobón (“Mama Angie”)
Business: Vital Ki Inc.
By signing this document, I acknowledge that I have carefully read, understood, and voluntarily agree to the following:
1. ACCURACY OF INFORMATION
I confirm that:
· I have completed the intake form truthfully and to the best of my knowledge.
· All medical, psychological, emotional, and personal information I have provided is accurate and complete.
· I have not knowingly withheld any information that could affect my participation or the safety of myself or others.
· I understand that providing inaccurate or incomplete information may increase the risks associated with participation.
2. NATURE OF THE PROGRAM
I understand that:
· The Primal Consciousness Program is an educational, personal development, spiritual growth, and self-awareness program.
· The purpose of this program is to support personal transformation, emotional awareness, energetic development, and expanded consciousness.
· This program is not psychotherapy, psychological counseling, medical treatment, or a substitute for licensed healthcare.
· I am participating voluntarily based on my own research, personal interest, and free choice.
3. VOLUNTARY PARTICIPATION
I acknowledge that:
· My participation is entirely voluntary.
· I may discontinue my participation at any time; however, I understand that choosing to withdraw does not entitle me to any refund.
· I agree to actively participate with honesty, integrity, respect, and personal responsibility.
· I agree to follow all instructions and guidelines provided by Angela Tobón, facilitators, assistants, guest teachers, and support staff.
· I understand that Vital Ki Inc. reserves the right to remove any participant whose behavior is disruptive, abusive, unsafe, disrespectful, or harmful to the learning environment, without refund.
4. PERSONAL RESPONSIBILITY & ASSUMPTION OF RISK
I understand that personal growth and transformational work can involve emotional, psychological, energetic, and spiritual challenges.
I acknowledge that I may experience:
· Emotional release
· Fear
· Sadness
· Anxiety
· Anger
· Grief
· Confusion
· Temporary discomfort
· Changes in beliefs or perspectives
· Physical sensations related to stress or emotional processing
I understand that meditation, breathwork, visualization exercises, emotional processing, energetic practices, and other transformational tools may temporarily alter my emotional or mental state.
I voluntarily assume full responsibility for my participation and accept all known and unknown risks associated with this work.
I understand that my personal transformation depends largely upon my own willingness, choices, commitment, and integration outside of the program.
5. NO MEDICAL, PSYCHOLOGICAL, OR THERAPEUTIC GUARANTEE
I acknowledge that:
· Angela Tobón, Vital Ki Inc., facilitators, assistants, and guest teachers are not acting as medical doctors, psychiatrists, psychologists, psychotherapists, or licensed healthcare providers unless specifically stated.
· No diagnosis, treatment, or cure for any physical, emotional, psychological, or medical condition is being offered.
· No guarantees or promises are made regarding any specific personal, emotional, financial, spiritual, or health outcomes.
· Every participant’s experience is unique.
6. CONFIDENTIALITY & COMMUNITY RESPECT
I agree to:
· Respect the privacy and confidentiality of all participants.
· Refrain from sharing another participant’s personal experiences, stories, or disclosures without their express permission.
· Participate in a manner that contributes to a safe, respectful, compassionate, and supportive learning environment.
7. RELEASE OF LIABILITY
To the fullest extent permitted by law, I voluntarily release, waive, discharge, and hold harmless:
Vital Ki Inc., Angela Tobón, all facilitators, assistants, volunteers, employees, contractors, guest teachers, associates, agents, successors, assigns, and representatives
from any and all claims, liabilities, damages, losses, costs, expenses, or causes of action arising directly or indirectly from my participation in the Primal Consciousness Program.
This release includes, but is not limited to:
· Physical injury
· Emotional distress
· Psychological discomfort
· Financial loss
· Property damage
· Spiritual experiences
· Any unforeseen consequences arising during or after participation.
8. INDEMNIFICATION
I agree to indemnify and hold harmless Vital Ki Inc. and its representatives against any claims, legal actions, damages, costs, or expenses arising from my participation or resulting from my own actions, omissions, or conduct.
This agreement shall be binding upon myself, my spouse, family members, heirs, executors, administrators, legal representatives, and assigns.
9. PAYMENT, CANCELLATION & REFUND POLICY
I understand and agree that:
· Full payment is required to reserve my place in the program unless a written payment plan has been approved by Vital Ki Inc.
· Due to the significant preparation, planning, scheduling, energetic commitment, and limited enrollment involved in this transformational program, all payments are non-refundable once the program has officially commenced, regardless of attendance, withdrawal, personal circumstances, scheduling conflicts, or early departure.
· If I choose to discontinue my participation after the program has begun, I remain responsible for the full program investment and understand that no refund, credit, or transfer will be issued.
· If Vital Ki Inc. cancels the program before it begins, I will receive either a full refund or the option to transfer my payment to a future offering.
· Any exceptions to this policy are solely at the discretion of Vital Ki Inc. and must be provided in writing.
10. ACKNOWLEDGEMENT
I confirm that:
· I have carefully read this entire Intake, Informed Consent & Liability Waiver.
· I have had sufficient time to consider its contents.
· I understand the nature of the program and the responsibilities associated with my participation.
· I understand that by signing this document, I am voluntarily giving up certain legal rights.
· I have had the opportunity to ask questions, and any questions I had have been answered to my satisfaction.
· I voluntarily choose to participate in the Primal Consciousness Program with full awareness and personal responsibility.
I further confirm that all information I have provided is true and accurate to the best of my knowledge.
I sign this agreement freely, knowingly, and without coercion.