INFORMED CONSENT, RELEASE, AND LIABILITY WAIVER
I CONFIRM THAT I PROVIDED COMPLETE AND ENTIRELY ACCURATE INFORMATION ABOVE.
I AM VOLUNTARILY VISITING THE OFFICE OF VALERIE HEMMING AND/OR BOOKING HER PRIVATELY AT MY HOME, PARTICIPATING IN ACTIVITIES THERE WITH THE KNOWLEDGE THAT THERE ARE RISKS AND DANGERS INVOLVED, INCLUDING THE POSSIBILITY OF INJURY, PROPERTY DAMAGE, OR EVEN DEATH FROM MANY POSSIBLE CAUSES, INCLUDING THE AGGRAVATION OF EXISTING SYMPTOMS, FORCE OF NATURE, WILDLIFE, ACCIDENT OR ILLNESS WITHOUT RAPID EVACUACTION OR ADEQUATE MEDICAL SUPPLIES OR SERVICES, STOLEN OR LOST PROPERTY, AND UNKNOWN CAUSES THAT NEITHER I NOR THE VALERIE HEMMING CAN ANTICIPATE.
IF I AM UNDER THE CARE OF A PSYCHOLOGIST, PSYCHIATRIST, OR DOCTOR FOR ANY MENTAL HEALTH OR PHYSICAL ILLNESS OR DIAGNOSIS, IBTAINED THEIR APPROVAL TO PARTICIPANTE IN ALL ACTIVITIES IN WHICH I WILL ENGAGE WHILE IN THE CARE OF VALERIE HEMMING.
OFFICERS, EMPLOYEES, MEMBERS, MANAGERS, AGENTS, AND VOLUNTEERS IN ASSOCIATE WITH VALERIE HEMMING ARE NOT LICENSED HEALTHCARE PROFESSIONALS. THEY ARE NOT QUALIFIED TO DIAGNOSE ILLNESSES, PRESCRIBE SUBSTANCES, OR PERFORM MEDICAL TREATMENT. THE SERVICES THEY OFFER ARE CONSIDERED COMPLIMENTARY TO, AND NOT A REPLACEMENT FOR, TRADITIONAL WESTERN MEDICAL PRACTICES.
SOUND HEALING SESSIONS MAY INVOLVE THE PLACEMENT OF VIBRATING OBJECTS NEAR OR ON THE BODY THAT EMIT VERY HIGH- OR LOW-PITCHED FREQUENCIES, AND LIGHT THERAPY INVOLVES EMITTING LOW-LEVEL PULSED LIGHT FREQUENCIES TO PARTS OF THE BODY. THESE ACTIVITIES MAY AGGRAVATE CERTAIN SYMPTOMS, CAUSE LIGHT-HEADEDNESS, AND PROVOKE MOOD CHANGES.
IF I EXPERIENCE ANY DISCOMFORT, PAIN, OR INJURY WHILE ENGAGING IN AN ACTIVITY WITH VALERIE HEMMING, I WILL IMMEDIATELY INFORM VALERIE HEMMING OR ANY REPRESENTATIVE.
IN ADDITION TO SOUND HEALING AND LIGHT THERAPY, OTHER ACTIVITIES IN WHICH I MAY PARTICIPATE WITH VALERIE HEMMING, INCLUDING PSYCHOTHERAPY, CRM, NATUROPATHIC MEDICINE, ENERGY WORK, YOGA, MEDITATION, PSYCHIC READINGS, MASSAGE, AND ACUPUNCTURE ARE METHODS TO WORK ON MY WELL-BEING. I RECOGNIZE THAT THESE TYPES OF ACTIVITIES CARRY RISKS. THERE ARE NO GUARANTEES OF WHAT I WILL EXPERIENCE. THESE ACTIVITIES MAY CAUSE ME TO DEAL WITH PROBLEMS IN MY LIFE OR UNCOMFORTABLE FEELINGS. MY PARTICIPATION MAY CAUSE ME TO EXPERIENCE HEIGHTENED EMOTIONAL OR PHYSICAL SENSATIONS, MEMORIES, AGITATION, OR FEELINGS OF SADNESS, GUILT, FRUSTRATION, LONELINESS, OR HELPLESSNESS.
IF I EXPERIENCE ANY UNCOMFORTABLE SENSATIONS OR FEELINGS WHILE WITH VALERIE HEMMING, I WILL IMMEDIATELY INFORM AN AUTHORIZED REPRESENTATIVE AND, IF I AM NO LONGER AT LOCATION, I WILL IMMEDIATELY CONTACT A LICENSED HEALTHCARE PROFESSIONAL.
I ACKNOWLEDGE MY RESPONSIBILITY FOR MY OWN WELFARE AND ACCEPT ALL RISKS OF PROPERTY DAMAGE, UNANTICIPATED EVENTS, ILLNESS, INJURY, EMOTIONAL TRAUMA, AND DEATH FROM BEING AT THE BACHMAN RANCH AND PARTICIPATING IN ACTIVITIES THERE. ACCORDINGLY, I FULLY AND IRREVOCABLY RELEASE AND FOREVER DISCHARGE BACHMAN RANCH, LLC AND ITS OFFICERS, EMPLOYEES, MEMBERS, MANAGERS, AGENTS, VOLUNTEERS, OTHER PARTICIPANTS, SPONSORS, AFFILIATES, AND UNAFFILIATED CONTRACT SERVICE PROVIDERS, AND EACH OF THEIR SUCCESSORS AND ASSIGN ("VALERIE HEMMING RELEASEES”) FROM ALL LIABILITIES, DAMAGES, COSTS, AND CLAIMS ARISING FROM OR IN ANY WHATSOEVER RELATED TO MY PRESENCE OF VALERIE HEMMING AND PARTICIPATION IN ACTIVITIES WHILE THERE, EVEN IF CAUSED BY the ALLEGED OR ACTUAL NEGLIGENCE OF A VALERIE HEMMING RELEASEE (BUT NOT IF CAUSED BY THEIR GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT).
THIS INFORMED CONSENT, RELEASE, AND LIABILITY WAIVER IS LEGALLY BINDING UPON ME PERSONALLY, ALL MEMBERS OF MY FAMILY, AND ALL OF MY HEIRS, SUCCESSORS, ASSIGNS, AND LEGAL REPRESENTATIVES. IT IS GOVERNED IN ALL RESPECTS BY THE LAWS OF TEXAS AND INTENDED TO BE AS BROAD AS PERMITTED BY THOSE LAWS. IF A COURT OR ARBITRATOR RULES THAT A TERM HEREOF IS UNENFORCEABLE, ALL THE OTHER TERMS WILL REMAIN IN EFFECT TO THE GREATEST EXTENT POSSIBLE.
I HAVE CAREFULLY READ AND FULLY UNDERSTAND THIS INFORMED CONSENT, RELEASE, AND LIABILITY WAIVER, WHICH IS A LEGALLY BINDING CONTRACT BETWEEN ME AND VALERIE HEMMING. WITH FULL KNOWLEDGE, I FREELY SIGN BELOW TO ACCEPT ALL OF THE FOREGOING TERMS.