CACAO CIRCLE PARTICIPANT WAIVER AND INFORMED CONSENT
Facilitator Name: Sun Star Healing & Myofascial Release
- Purpose of the Cacao Circle: I understand the circle I am participating in involves therapeutic use of cacao. The circle also includes, but is not limited to breathwork, movement, meditation, sound and gentle hands on healing. These activities are intended to support emotional, physical, and spiritual well-being.
- Acknowledgment of Risks:
- Raw cacao contains a natural stimulant, theobromine, and may increase heart rate or affect blood pressure. I confirm that I do not have any known allergies to cacao.
- Participants who are pregnant; may be pregnant; nursing; have high or low blood pressure; anxiety disorders; or those on antidepressants should consider consulting their physician before consuming cacao.
- The session may include “laying of the plants” which involves placing a plant with leaves and/or flowers on a person. If a participant has any known allergies to plants or flowers, they must disclose such allergy(s) to the facilitator before the event via email: sunstarhealmfr@gmail.com
- Assumption of Responsibility: I understand and acknowledge I will be consuming cacao and assume full responsibility for my own physical and emotional well-being during and after the session. I will notify the facilitator of any discomfort or adverse reaction.
- Liability Waiver:
In consideration of being allowed to participate, I hereby:
- Waive and release the facilitator(s), business entity, and any associated parties from any and all liability, claims, demands, or causes of action arising out of or related to any loss, damage, injury, or illness.
- Agree to hold harmless and indemnify the above-mentioned parties from any claims brought by me or any third party on my behalf.
- Confidentiality: Any personal disclosures or experiences shared during the circle by myself or others will be treated with respect and confidentiality by the facilitator and participants, to the extent permitted by law.
- Cancellation Policy: Participants are required to provide written notice a minimum of 24 hours prior to the circle to be eligible for a refund.
- Consent: I acknowledge I am at least 21 years of age and have read this waiver and informed consent form in full. I fully understand its contents and voluntarily agree to the terms and conditions stated herein.
- Photo and Video Content:I accept that photos and videos may be taken during the cacao circle for marketing purposes. All efforts will be made to not to include any identifying features of participants for privacy.
I have read and agree with the terms outlined in this waiver and informed consent.