Waiver and Medical Conditions

“Awake my Dear ~ Be Kind to your sleeping heart. Take it out into the vast fields of Light and let it breathe.”

Hafiz

Waiver & Medical Conditions form

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Medical Waiver
Name
Name
First
Last

Type of Instruction

Medical Conditions

Please indicate any conditions that apply to you

Emergency Contact Info

Name
Name
First
Last
WAIVER and RELEASE OF INDEMNITY
Additional Zoom Waiver

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