Liability Release Form

This Release is made in favor of “Releasees”, who include Katy Haldiman, guest speakers/instructors/teachers, contributors, staff and volunteers (collectively “Facilitators”), and the owners and operators of the premises upon which the program/class is being conducted (all collectively the “Program”). The consideration for this Release is the permission given to Releasor (“Participant”) to participate in the Program.

Participant understands that participation in the Program may involve physical, non-physical and emotional exertion. Participant warrants that he/she has no disability, impairment, ailment or other condition that would be adversely affected by participation in the Program.

Participant understands the Program is not “therapeutic” and no one associated with Releasees has made any medical claims or representations of cures to Participant.

Participant acknowledges and agrees that his/her entitlement to participate in the Program is at Releasee’s sole discretion and may be terminated at the sole discretion of Releasee for any reason at any time. If Participant withdraws from the Program for any reason whatsoever, no part of the Program fee shall be refunded and any unpaid portion thereof shall become due and payable immediately from Participant to Releasee.

Participant shall participate in the Program, and use the facilities, services, and any equipment provided by Releasees, all at his/her own risk.

Participant hereby releases and discharges Releasees, all Releasees’ officers, directors, employees, consultants, staff, volunteers, agents, successors, assigns and legal representatives and each and any of their affiliates, agents, co-instructors, and employees, from any and all claims, demands, or actions for loss, damage or injury, known or unknown, physical or mental, arising out of Participant’s participation in the Program or the use of any facility, service or equipment provided by Releasees, including but not limited to any claim for personal injuries resulting from or arising out of negligence of Releasees, all Releasees’ officers, directors, employees, consultants, staff, volunteers, agents, successors, assigns and legal representatives or any of their affiliates, agents, co-instructors, and employees, or any other person, including, without limitation, other participants in the Program, during the Program and on any premises or location upon which any aspect of the Program is held or conducted, and including but not limited to during any travel to or from any location or premises at which any aspect of the Program is held or conducted, whether that travel is in private or public transportation, or in transportation provided by a participant or by any of the Releasees. T

his Release binds not only Participant with regard to any claims arising from participation in this activity, but also Participant’s spouse, heirs, assigns,executors, administrators, and legal representatives.

Participant acknowledges and agrees that all material (with the exception of what the Participant offers to the Program) used during the Program is and shall remain the sole property of the Sponsor and/or Facilitators exclusively for their own use and that the Participant’s retention, publication, dissemination or use (other than within the Program) of any such materials is prohibited.

Participant has carefully read this Agreement and agrees to be bound by it, including but not limited to Participant’s release and waiver of liability above. If any portion of this Release shall be held invalid under any applicable state law, those parts that are not held invalid shall continue in full force and effect. This Agreement contains the entire understanding of the parties and may not be modified except by a writing signed by both parties. No other representations or promises have been made to induce Participant to agree to this Agreement.

This Agreement shall be governed by the laws of the State of Hawai’i.