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Spiritual Counseling

Life Coaching

Energy Work

Meditation

RELEASE OF LIABILITY 

I am about to engage in an activity that is spiritually led, which may have unanticipated results physically, emotionally, and mentally. I understand the risks involved and believe I am competent to care for my own safety. Setting aside gross negligence on the practitioner’s part, I assume full financial responsibility for my care if I am injured either during the activity or going to or coming from the activity. Therefore:

1)    I release TONGASS TEAGUE LLC and their owners, agents, and employees of any liability association with my participation in activities offered by them, including sessions or workshops that involve contact between two or more people or direct application of principles through life coaching, spiritual counseling, energy work, healing, meditation, and so forth.

2)    I agree to protect, indemnify, and hold TONGASS TEAGUE LLC and their owners, agents, and employees harmless from and against any and all loss, costs, expense, damage, or liability arising out of any legal action I initiate against them that violates the above release.

3)     If any legal action is initiated against TONGASS TEAGUE LLC and their owners, agents, and/or employees, I agree that the legal action shall be governed and construed in accordance with the laws of the State of Alaska, U.S.A. without regard to conflicts of law principles. I also agree and submit to the jurisdiction of any court or competent jurisdiction within the City and Bureau of Ketchikan, Alaska, with respect to any claim, controversy, causes of action or suit arising out of or related to this agreement. 

4)   If I am unable to be consulted about emergency medical care, I authorize TONGASS TEAGUE LLC and their owners, agents, and employees to obtain medical help on my behalf. This authorization includes but is not limited to permission to call 911, to authorize emergency medical care by appropriately licensed personnel and transport to and treatment by the nearest appropriate facility.

I Agree

April 27, 2024

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

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Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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