Liability Waiver

Before we dive into this experience together, I ask that you take a moment to read through and complete the liability waiver below. This simply makes sure you understand the nature of the program, the possible risks, and your own responsibility while attending.

Thank you for taking care of this step. It helps me create a safe, supportive space where we can keep the focus on your growth, connection, and all the magic that’s waiting for you.

Name(Required)
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EMERGENCY CONTACT NAME AND TELEPHONE NUMBERS
Emergency Contact's Name(Required)
IF YOUR PRIMARY EMERGENCY CONTACT IS UNAVAILABLE, ALTERNATE EMERGENCY CONTACT NAME AND TELEPHONE NUMBERS
Alternate Emergency Contact's Name(Required)
HEALTH INSURANCE FOR TRAVEL INFORMATION

By signing this waiver, you agree that you may be giving up legal rights and remedies available to yourself. Read and complete this waiver carefully. If you have questions, contact an attorney.

I understand that the nature of the program is both social and spiritual in nature and is open to everyone. The program will take place at a variety of locations worldwide throughout the year.

Nature of Risks: I understand that voluntarily traveling to and attending the program may involve certain risks beyond the reasonable control of its staff, director, volunteers, and agents in connection with the various retreats and trips, including but not limited to accidents, emergencies, exposure to reckless conduct of other persons, and/or negligence of Retreat Centers, Hotels et al., disclaim any and all responsibility for any such risks.

Waiver of Liability/Hold Harmless: By signing this liability waiver, I agree and acknowledge that I may be giving up important legal rights and remedies available to myself. For value received, I agree on behalf of myself that I assume all risks and waive any liability of any nature whatsoever against and agree to hold harmless Jodie Harvala, with respect to any and all actions, claims or demands that may be made or brought on our behalf against Jodie Harvala, arising out of or in connection with travel to or attendance at the program, or any other activity I may engage in while in transport there. Further, for value received, for any injury to third parties that may arise because of my actions or omissions, I agree to hold harmless and defend Jodie Harvala, with respect to any and all actions, claims, expenses or demands arising there that may be made or brought against Jodie Harvala, including but not limited to reasonable attorneys’ fees and expenses arising in connection therewith.

Please note: Wearing a face mask will be up to each individual person’s choice. If you are comfortable with attending knowing this, then we welcome you with open arms. By signing this form, you are confirming that you are taking full responsibility and liability for your health and your choice as an individual to attend, whether others wear a mask or not.

Media Waiver: We consent to the use by Jodie Harvala, of any videotape, photograph, slide, audiotape, or any other visual or audio reproduction in which I may appear. I understand that these materials are being used for promotion of various retreats and trips by and for Jodie Harvala. Such promotional activities extend to recruitment, fund-raising, advocacy, etc. I release Jodie Harvala, from any liability connected with the use of my picture or voice recording as part of any of the above or similar activities.

Medical Permissions (Limited): As a condition of attending the various events, I grant permission in the event of an emergency or accident for emergency medical care to be administered within the Facility and/or during or after transportation to a hospital or doctor for emergency medical care. I further understand that it is not the responsibility of Jodie Harvala to attempt to reach my emergency contacts and that I remain responsible for my medical expenses.

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Break the Rules. Break the Patterns. Break Wide Open. Join Jodie starting on February 1st for a month-long uprising for women who are done playing small in love and money.

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