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Consent to Receive Services and Release from Liability

I hereby release Rev. Sydney Finn, their contractors, agents, employees, successors and assigns, and their respective heirs, personal representative, affiliates, and any or all persons, liable or who might be claimed to be liable, whether or not here in named, none of whom admit any liability to the undersigned, but all expressly denying liability, for any, and all actions, causes of action, claims and demands of any and every kind and also any all injuries and damages that may occur in the present or develop in the future. I am over 18 years of age; or, I am in the parent or legal guardian of the subject of the workshop participant or client. I am currently under the care of a physician or other health care practitioner. I understand that no physician-patient relationship is established through my participation in workshops or sessions. I understand that this is not psychotherapy.

I understand that I will be receiving an energy work session and that the purpose of the session is for the well being of my heart and mind. I understand that there is no implied or stated guarantee of success or effectiveness of individual technique or series of appointments. I hereby acknowledge that this is not a substitute for medical care, examination or diagnosis. Rev. Sydney Finn does not diagnose, give medical advice, or make a claim to cure, or predict the future. We reserve the right to refuse service to anyone.

Dispute Resolution: Rev. Sydney Finn and the Client agree to first enter into negotiations to resolve any controversy, claim or despite ("dispute") arising under or related to this Contract. The parties agree to negotiate in good faith to reach a mutually agreeable resolution of such dispute within a reasonable period of time. If good faith negotiations are unsuccessful, the such dispute will be mediated by a mutually-acceptable mediator to be chosen by the parties within fifteen (15) business days after written notice by one of the parties demanding mediation. Neither party may unreasonably withhold consent to the selection of the mediator. The parties agree to share the cost of the mediation equally. Such mediation will take place in San Francisco, California. If the dispute cannot be resolved by the parties through negotiation or mediation within forty-five (45) days of the date of the initial demand for mediation by one of the parties, then either party may seek resolution of the dispute as otherwise provided in this Contract and by laws of the State of California.

Governing Law/Venue: This agreement shall be governed and construed in accordance with the laws of the State of California. Any claim, action, or suit between Rev. Sydney Finn and the Client that arise out of or relates to performance of this agreement shall be brought and conducted solely and exclusively within the Circuit Court of San Francisco County, California. Provided, however, that if such a claim, action or suit may be brought only in a federal forum, it shall be brought and conducted solely and exclusively within the United States District Court of California. Client, by execution of this agreement, hereby consents to the in personal jurisdiction of said courts.

I Agree

April 20, 2024

First Client Name

First Name*

Middle Name

Last Name*

Phone*
First Client Date of Birth*
First Client Signature*
Second Client Name

First Name*

Middle Name

Last Name*
Second Client Date of Birth*
Third Client Name

First Name*

Middle Name

Last Name*
Third Client Date of Birth*
Fourth Client Name

First Name*

Middle Name

Last Name*
Fourth Client Date of Birth*
Fifth Client Name

First Name*

Middle Name

Last Name*
Fifth Client Date of Birth*
Sixth Client Name

First Name*

Middle Name

Last Name*
Sixth Client Date of Birth*
Seventh Client Name

First Name*

Middle Name

Last Name*
Seventh Client Date of Birth*
Eighth Client Name

First Name*

Middle Name

Last Name*
Eighth Client Date of Birth*
Ninth Client Name

First Name*

Middle Name

Last Name*
Ninth Client Date of Birth*
Tenth Client Name

First Name*

Middle Name

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

Email*

Confirm Email*
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 Date of Birth*
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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