DEEP ROOTS APOTHEKE’ & CLINIC LLC (“Deep Roots”) offers consulting services for education and empowerment in reclaiming their health through herbal medicine and whole foods (the “Services”, any individual service, a “Service”) to its clients (those clients, “Clients” any individual client, “Client”). In an effort to provide the Services in the best possible way, all Clients must sign this release and agree to the Terms and Conditions prior to receiving the Services.
By signing this waiver, I am confirming that I recognize that there may be inherent risks associated with using certain herbal medicine, participating in programs, or receiving Services.
I agree that I am responsible for my own health.
I understand that the employees and contractors for Deep Roots are not health care practitioners and cannot be expected to diagnose or treat individual health problems.
I understand that I am responsible for discussing any questions I may have concerning my health conditions prior to participating in any Services.
I agree that, should health-related symptoms occur, I will stop the Service and inform Deep Roots personnel of my symptoms immediately.
I assume all risk of any injury, including serious physical injury and death, presented by or caused in any way by or related to my use of the Services or my presence at the clinic.
I agree that my participation in the Services or use of the Deep Roots facilities will also be subject to the Terms of Service, which is available at the Deep Roots website.
I agree any fees or related costs associated with my use of the Services will be subject to the Terms of Service.
I agree that I may be photographed or video recorded during my participation in the Services and that Deep Roots may use the images or recording for promotional materials.
I agree there are no updates to the information I have previously provided to Deep Roots.
If I have reason to believe that medical clearance should be obtained prior to participation in any Services offered by Deep Roots, I agree that I have first consulted a physician and obtained permission prior to the commencement of any Services.
By voluntarily choosing to receive Services from Deep Roots, I warrant that to the best of my knowledge, I have no disability, impairment or ailment that prevents me from receiving such Services.
By participating in the Services, I release Deep Roots (and its respective officers, directors, members, employees, and contractors) and waive any claims, liabilities, or damages for personal injuries I may experience directly or indirectly from receiving Services from Deep Roots, utilizing the clinic, or participating in the programs or activities offered by Deep Roots.
Herbal Medicine and Nutrition Services
I understand that Deep Roots offers herbal medicine and nutrition services. Cameron Strouss is a clinical herbalist and is not a doctor, physician or surgeon, and as such, does not diagnose, treat, correct, or prescribe for any human disease, ailment, injury, pain, or other condition outside of herbal medicine and nutrition guidance. If I experience any pain, discomfort, or negative reaction to any herbal medicine or dietary advice, I will listen to my body, discontinue the activity, and ask for support from the counselor. I assume full responsibility for any and all damages which I may incur through participation. To ensure a comfortable, clean and safe consultation, each time Client participates in a Class, Client agrees to the following:
Client is not under the influence of illegal drugs or alcohol.
Client does not have any condition which may be adversely affected by participating in the Services.
Client is not currently using any medications that will be adversely affected by participating in the Services.
Client authorizes Deep Roots to call emergency medical staff or Client’s emergency contact in the event of any emergency.
Client releases Deep Roots of any liability for any injury to Client or loss of personal items while using any of the Services.
If Client is under the age of 18, this waiver must be signed by a parent or guardian.
BY SIGNING THIS WAIVER, CLIENT (OR A GUARDIAN ON BEHALF OF A MINOR) ALSO AGREES TO THE TERMS OF SERVICE FOUND ON THE DEEP ROOTS WEBSITE.