GENERAL LIABILITY WAIVER AND INFORMED CONSENT AGREEMENT
PLEASE READ CAREFULLY. BY REGISTERING FOR OR PARTICIPATING IN ANY SERVICE OFFERED BY Paula Kettula Licensed Clinical Social Worker Inc., doing business as Porta Verum Psychotherapy Services (herein referred to as "Porta Verum"), YOU ACKNOWLEDGE AND AGREE TO THE TERMS BELOW. This General Liability Waiver ("Agreement") is entered into by and between the undersigned client ("Client") and Paula Kettula Licensed Clinical Social Worker Inc., doing business as Porta Verum Psychotherapy Services ("Porta Verum"), a California professional corporation, offering yoga, meditation, psychotherapy, and mental health-related workshops (collectively, the "Services").
1. Voluntary Participation and Assumption of Risk I understand that participation in yoga, meditation, mental health workshops, and related Services may involve physical, emotional, and psychological exertion. I acknowledge that such activities carry inherent risks, including but not limited to physical injury, emotional distress, or exacerbation of existing mental health symptoms. I confirm that I am voluntarily choosing to participate in these Services and assume full responsibility for any risks, injuries, or damages that I may incur as a result of my participation.
2. Nature of Somatic and Yoga-Based Practices Somatic and yoga therapy interventions invite you to connect to your body through awareness, conscious breathing, and mindful movement. Working with emotions and body sensations can sometimes be uncomfortable. It is necessary that you honor your own limits and boundaries throughout participation. It is important that you feel comfortable communicating if any intervention offered does not feel right for you. You may discontinue engaging in somatic or yoga interventions at any time.
3. Health and Medical Conditions I certify that I am physically, mentally, and emotionally fit to participate in the Services provided. I understand it is my responsibility to consult with a physician or licensed healthcare provider prior to participation, particularly if I have any condition that may be affected by physical activity, breathwork, meditation, or emotional processing. I agree to inform Porta Verum of any medical, psychological, or psychiatric conditions that may impact my participation.
If you have any physical concerns or fear of injury, it is especially important that these are communicated before and throughout participation. It is important to listen to your own body to ensure that you do not exert yourself beyond your capacity. Breath and movement practices should not worsen any existing physical conditions, and you are encouraged to modify or rest at any time.
I affirm that it is my responsibility to ensure I am physically and medically cleared to safely participate in yoga-based interventions, which may include consulting medical professionals to ascertain the appropriateness of these practices for my health.
4. No Guarantee of Results or Clinical Services I understand that yoga, meditation, and workshops offered by Porta Verum are intended for personal growth, education, and wellness and do not constitute medical or psychotherapeutic treatment unless explicitly conducted under a licensed professional's care with an established therapeutic relationship. No guarantees have been made regarding the outcome or effectiveness of any Service.
5. Waiver and Release of Liability To the fullest extent permitted by law, I, on behalf of myself, my heirs, executors, and assigns, hereby waive, release, and discharge Paula Kettula Licensed Clinical Social Worker Inc., doing business as Porta Verum Psychotherapy Services, its owners, officers, employees, independent contractors, and affiliates from any and all claims, demands, damages, liabilities, or causes of action arising from or related to my participation in the Services, including but not limited to personal injury, psychological harm, or loss of property, whether arising from negligence or otherwise.
6. Indemnification I agree to indemnify, defend, and hold harmless Porta Verum and its affiliates from any and all liabilities, claims, expenses, or losses, including attorney's fees, arising from my participation in the Services or breach of this Agreement.
7. Use of Digital Platforms I understand that some Services may be provided through online platforms, and I assume all risks related to the use of third-party applications or the potential for unauthorized access to data or confidentiality limitations in such settings.
8. Severability If any part of this Agreement is found unenforceable, the remaining provisions shall remain in full force and effect.
9. Governing Law This Agreement shall be governed by and interpreted in accordance with the laws of the State of California.
BY CLICKING "I AGREE," YOU ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD, AND AGREE TO THIS LIABILITY WAIVER.