Treatment Waiver

Clients will automatically receive a copy of this Waiver once it’s submitted. Please check your “junk folder.”

I, the undersigned [“Client”], am a paying participant in Reiki, Reflexology, and/or Somayog Assisted Exercise (SAE) session(s) [“Services”] offered by Sandra Hamelmann [“Practitioner”] at [“Studio”].

I understand there are obvious risks inherent in these Services, and I affirm I am in proper physical condition to participate in Services. I know I am held to understand and appreciate the risks of participating in Services, and I voluntarily assume all risks.

I agree that Services offered by Practitioner and/or Studio are not a substitute for medical attention and not intended to medically examine, medically diagnose, or medically treat any condition. I understand it is my responsibility to consult a physician prior to and during participation in Services.

Based upon my representation that I am in proper physical health and conditioning to participate in Services offered by Studio and/or Practitioner, I agree:

  1. To assume all risk of injury to myself and all risk of damage to and loss of my property arising out of my participation in Services;
  2. To not engage in any inappropriate conduct that could result in injury to myself or others. If I experience any pain or discomfort during Services, I will immediately disengage in the activity and let the Practitioner know. If pain or discomfort persists, I will immediately seek medical attention;
  3. To consult a physician about participating in Services if my health condition changes during ongoing participation. If physician advises me to discontinue Services, I will comply;
  4. To release and forever discharge the Studio and/or Practitioner, its officers, employees, agents, students, and heirs from any and all liability for any injury, including death, and for property damage or loss which may be suffered by myself, arising out of or in any way connected with my participation in Services; and;
  5. For myself, my heirs, executors, administrators, and assigns, to indemnify and hold harmless the Studio and Practitioner, its officers, employees, agents and students from any and all liability, claims, demands, actions, loss and damage arising out of my participation in Services.

I also agree to the following terms:

  1. All payments are made prior to Services.
  2. If Client is late for Class and/or Service, appointment will be shortened.
  3. If Practitioner travels to a client’s home for Services, Client will pay for return taxi fare (with cash) upon arrival. If payment isn’t made immediately, Practitioner can refuse Service without refund.
  4. All payments are final. No cancellations or refunds.
  5. If repeat Client temporarily discontinues Services, they may lose their preferred time slot.
  6. Practitioner reserves the right to refuse Services to Client without explanation. If Client is owed Services at time of termination, Practitioner will issue refund for remaining balance on Services.
  7. Practitioner reserves the right to reschedule Services due to poor health; internet, electrical and/or computer issues; or emergency.
  8. If Client misses an online Class and/or Service due to failing internet, Practitioner will reschedule if Client emails Practitioner a screen shot proving their internet was down at time of Class and/or Service.  If said screenshot isn’t produced, Practitioner will not be obligated to reschedule.
  9. Client consents to allowing Practitioner to touch them during Services in order to adjust alignment and/or to facilitate the release of muscle tension.

By submitting this form, I state that I have carefully read this entire agreement and fully understand its contents. I am aware that this is a release of liability and a contract between myself and the Studio and/or Practitioner, and I sign it of my own free will.

By electronically signing this form below, I understand that an electronic signature has the same legal effect and can be enforced in the same manner as a written signature.


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