INTAKE FORM SHAMANIC RETREATS

I agree to the terms & conditions. I, the undersigned applicant and participant, am freely signing this agreement. I hereby release and agree to waive liability, from and against any and all damages and claims of any kind, known or unknown, that may be connected, are the result of, or arising from consideration, preparation, implementation, or participation in the retreat, against Neten - Education and Alternative Therapy Center and all its respective representatives. This includes but is not limited to, claims involving economic loss, illness or medical condition, injury, or accidental death. I acknowledge having read and understood this Release of Liability. I, the Client, agree with this Release of Liability and precisely express full understanding and it has not been modified orally or in writing. I state that I have answered the Pre-Screening Questionnaire truthfully and completely and am free from any known or unknown heart, physical, mental, drug, or any other health problems that could prevent them from participating or cause complications during my participation. I agree that my safety is primarily dependent upon taking proper care of myself during this Plant Medicine retreat /ceremony and following all pre and post-plant medicine ceremony/retreat, dietary, and health guidelines, including abstaining from medications and drugs. I also consent that my name, image, or any other information be used or displayed on social channels or other online platforms.Terms & conditions

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Please note that the information you provide here will be protected and treated with the utmost confidentiality. These questions help me provide you with the safest environment and highest level of care I can. It is essential to the process that you answer with openness and complete honesty.

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