This is the registration form for Sound, Healing and Consciousness Module 1 2019, April 2019 within Leyden, Massachusetts . Please add the registration to your cart and check out after you are done filling it out. It will ask for billing and shipping information, but there is no charge for this form. We are simply asking for this information in providing appropriate services for you.
*RELEASE AND ASSUMPTION OF RISK
I am aware that during the expedition, workshop or activity (hereafter referred to as ‘Activity’) in which I am participating through Zacciah Blackburn, and The Center of Light, in Vermont, (aka The Center of Light Institute of Sound Healing and Shamanic Studies,) and arrangements made through those individuals and organizations, and their associates, I may incur certain risks, including but not limited to, the dangers of traveling in high altitudes, hiking, swimming, mountain climbing, travel by air, boat, automobile, bus or other conveyance, loss or damage to personal property, injury or fatality due to high altitudes, accident or illness in a remote place without medical facilities, water damage due to leaking bags or other containers, exposure to inclement weather, forces of nature and other risks and dangers.
In consideration of, and as part of payment for the right to participate in the Activity and the service provided by and arranged for by Zacciah Blackburn, and the Center of Light, and their associates, I hereby assume all risks and release and waive all claims against Zacciah Blackburn, and the Center of Light, and its employees, associates, and representatives, and will hold them harmless from any and all liability, action, cause of action, debts, negligence, claims, demands and damages of every kind or nature whatsoever, whether direct or indirect, contingent, consequential or otherwise, against them, which I now have or which may arise out of, or be brought by a third party in connection with my participation in the Activity or any other activities arranged by, through or with Zacciah Blackburn or the Center of Light, or their associates. This agreement shall serve as a release, assumption of risk and hold harmless provision for me, my heirs, including any minors, participating in these activities.
I have read and agree to these terms and conditions. I understand that Zacciah Blackburn and the Center of Light, and their associates, rely on this release in allowing me to participate in these activities.