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CLIENT
INTAKE
WAIVER

 

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Client Intake Release + Waiver

Before we dive in - let's get clear on the nitty gritty shall we? Please thoroughly review and complete the below.

All clients are required to complete this form prior to our first coaching or consultation call. Got a question or concern? Shoot me a note!

Name *
Name
I hereby agree I have engaged Rachel Ricketts to assist me with anti-racism + inclusion training and/or intuitive grief coaching re navigating racist patriarchy (a "Session"). Where applicable, a Session is not meant to replace counseling or be a substitute for it, nor is it appropriate for people in crisis of any kind. Outcomes are not guaranteed. I hereby agree and acknowledge that I am of sound mental capacity and will alert Rachel Ricketts or her agents/assigns if and when this changes. I understand that any exercises and information offered during a Session are done so to increase my knowledge of and access to support for assisting my own well-being and/or committing to and promoting racial justice. I am free to decline my participation in any resource or Session at any time and understand that I will not receive a refund should I choose to do so. I take full responsibility for the application of any of the information, exercises (including but not limited to breathwork, yoga, meditation, oracle card readings, journaling and Reiki) or resources presented in a Session. I hereby agree this relationship shall be governed by mutual respect. Rachel Ricketts reserves the right to deny or discontinue a Session and/or her services at anytime should she, in her sole opinion, deem my words, actions or behaviours to be harmful to her, myself or anyone else. I may not copy, sell, loan, use, or in any way reproduce the content or materials offered by or through Rachel Ricketts during a Session or otherwise unless expressly authorized in writing. I understand that Rachel Ricketts is a practicing lawyer but nothing she shares in my Session is or shall be deemed to be legal advice. I release Rachel Ricketts and any of her successors, employees, contractors, agents, heirs, next of kin, administrators or assigns (collectively the “Released Parties”) from claims, demands, damages, actions or causes of actions arising out of or in consequence of any loss, injury or damage to any person or property arising directly or indirectly from my participation in a Session. Notwithstanding if the loss, injury or damage may have arisen by reason of negligence, or any claims made upon any guests or presenters. I have read and agree to the Terms of Sale and Privacy Policy set out on Rachel Ricketts' website (in the footer). If any provision of this Agreement shall be unlawful, void or for any reason unenforceable, then that provision shall be deemed severable from this agreement and shall not affect the validity and enforceability of any remaining provisions. This Agreement shall be governed by and construed in accordance with the laws of the Province of British Columbia and the federal laws of Canada applicable therein. My first Session is contingent upon my completion and return of this Client Intake Release + Waiver and the terms of this Agreement shall endure until the end of my engagement with Rachel Ricketts. Rachel Ricketts may deny or discontinue my participation for a violation of the terms herein. BY INITIALING BELOW, I am stating that (a) I have read and agree with the above information in this Intake Release + Form for a Session and have had an opportunity to seek independent legal advice, (b) I fully understand all of its terms and conditions and I recognize and accept the risks in participating in a Session and (c) this Agreement is legally binding of full force and effect and my digital initials shall be deemed an original signature.
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