• The Green Room Sound Bath Waiver & Release of Liability Form

    Please read the terms carefully, provide your information, and sign electronically to acknowledge and accept the terms and conditions.
  • Format: (000) 000-0000.
  •  SOUND BATH WAIVER, RELEASE OF LIABILITY & TERMS OF PARTICIPATION

    By checking this box, I acknowledge and agree to the following:

    I understand my participation is completely voluntary and I may stop participation at any time.

    I understand that participation in sound bath sessions, meditation experiences, breathwork, wellness events, and related activities hosted at The Green Room and/or facilitated by Loriel Samaras may involve inherent physical, emotional, and psychological risks. These may include but are not limited to dizziness, emotional release, anxiety, discomfort from sound frequencies or vibrations, aggravation of pre-existing conditions, slips, falls, or other unforeseen reactions.

    I affirm that I am voluntarily participating and that I am physically, mentally, and emotionally able to participate. I understand that sound baths and wellness experiences are not medical treatment, psychotherapy, or a substitute for professional medical advice, diagnosis, or treatment.

    I understand that if I am pregnant, have epilepsy or seizure disorders, severe mental health conditions, sound sensitivity, hearing conditions, a pacemaker, metal implants, or any other medical concern that may be affected by sound vibration or meditation practices, it is my responsibility to consult a physician before participating.

    I agree to listen carefully to all instructions provided by Loriel Samaras and event staff and to participate responsibly and within my own limits.

    To the fullest extent permitted by California law, I hereby release, waive, discharge, and hold harmless The Green Room, Loriel Samaras, The Higher Path, The Ohter Path, their owners, employees, contractors, agents, affiliates, volunteers, and representatives from any and all claims, liabilities, damages, or causes of action arising from participation in these activities, including claims arising from ordinary negligence.

    I understand and agree that this waiver does not apply to gross negligence, reckless conduct, or intentional misconduct.

    I consent to receive emergency medical treatment if deemed necessary during the event and accept full responsibility for any related costs.

    The Green Room and Loriel Samaras reserve the right to refuse entry or remove participants who appear intoxicated, disruptive, unsafe, or unwilling to follow instructions. No refunds may be issued in these circumstances. 

    I knowingly and voluntarily assume all risks associated with participation in this event.

    Photos or videos may be captured during the event for promotional purposes. Participants may opt out by notifying staff before the event begins.

    I certify that I am at least 18 years old, or that a parent/legal guardian is signing on my behalf.

    By checking this box and typing my name below, I acknowledge that this constitutes my electronic signature and legally binding agreement to these Terms & Conditions and Release of Liability.

  • Emergency Contact Information

  • Format: (000) 000-0000.
  • Terms and conditions*
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