RELEASE, WAIVER OF LIABILITY and ASSUMPTION OF RISK
Life Practice Program. Meditation learning & support.
In Consideration of being permitted to observe and participate in the Life Practice Program (the “Program”), I, on behalf of myself, my personal representatives, heirs, and next of kin:
1. Acknowledge, agree, and represent that I am aware of the possible reactions that can occur during and after meditation, including without limitation:
- Increased emotional sensitivity;
- Heightened states of anxiety and depression;
- Exacerbation of compulsive and other driven behavior;
- Reappearance of negative behavior patterns from past;
- Altered states including visions and hallucinations;
- Reappearance of psychotic symptoms;
- Rekindling of depression or other psychiatric disorders; and/or
- Exacerbation of physical pain and discomfort.
I hereby agree, if I am under the care of a medical or other therapeutic provider for emotional or psychological problems, suffer from any of the conditions set forth above, or am taking any form of psychotropic medication including but not limited to anti-anxiety, anti-depression, or anti-psychotic medications, to consult with and obtain the advice and consent of my medical or other therapeutic provider.
2. Hereby release, waive, discharge and covenant not to sue Shinzen Young or 03 Life Practice LLC (“03”) or its members, managers, representatives, agents or employees (collectively, the “Releasees”), from any and all liability to me, my personal representative, assigns, heirs, and next of kin for any and all loss or damage and any claim or demand therefore on account of injury of any kind to, including without limitation injury resulting in the death of, the undersigned, arising out of or related to my participation in the program, whether caused by the negligence of the Releasees or otherwise.
3. Hereby represent and warrant to Shinzen Young, 03 and any and all other persons responsible for the conduct of the program that if I have previously experienced severe negative reactions to introspective practice or have reason to believe that I will experience a severe negative reactive to introspective practice, or if I suffer from any severe emotional or psychological condition, I agree to seek advice from a competent medical or other psychotherapeutic professional and obtain his or her consent before participating in this program. I acknowledge that I have been informed of the potentially stressful nature of participation in the program. I further acknowledge that 03 and Shinzen Young have agreed to allow me to participate in the program in reliance on the foregoing representation, warranty and acknowledgment.
4. Hereby assume full responsibility for any risk of mental or bodily injury (including any such injury which results in my death) arising out of or related to the Program, whether caused by the negligence of Releasees or otherwise.
5. Hereby agree that this Release, Waiver of Liability and Assumption of Risk extends to all acts and omissions by the Releasees, and is intended to be as broad and inclusive as is permitted by the laws of the applicable jurisdiction(s), and that if any portion hereof is held invalid, it is agreed that the balance hereof shall, notwithstanding, continue in full legal force and effect.
I have read this Release, Waiver of Liability and Assumption of Risk, fully understand its terms, understand that I have given up substantial rights by agreeing to it, and have executed it freely and voluntarily without any inducement, assurance or guarantee being made to me, and intend my execution hereof to be a complete and unconditional release of all liability to the greatest extent allowed by law.