Christian Professionals’ Resilience Program Waiver & Release Form

for Krystyna Kidson - Psychologist - Coach - Supervisor

and Clients and Potential Clients of Krystyna Kidson
as of June 1, 2024

1. Participation and Safety

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If at any time during the CPR Coaching Program, you experience any emotional and/or physical discomfort or strain, discontinue the activity, and if required, ask for support from the facilitator. The CPR Coaching Program may require mild physical exertion and exercise, movement, sitting during mindfulness or meditation/contemplation, and stretching. The use of nutritional supplements and sleep hygiene may also be mentioned at times.

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2. Risk of Injury

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As is the case with any physical activity, the risk of injury is present and cannot be entirely eliminated. While the program is designed to be safe, participants acknowledge that injuries or other unforeseen challenges may occur.

 

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3. Non-Clinical Nature

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The CPR Coaching Program is not a clinical or diagnostic service and is not a substitute for individual physical or psychological therapy, or medical examination, diagnosis, or treatment. The CPR Coaching Program (or elements thereof) may not be safe for those with certain medical conditions (e.g., vagal breathing when fitted with a pacemaker, relaxation exercises with active unresolved trauma, omega-3 supplementation when on blood-thinning medication). You should consult with your relevant health practitioner prior to commencing the program.

 

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4. Acknowledgment and Agreement

 

By signing this form, I acknowledge that I have read and understood this form, and I agree to the following:

 

4.1. Medical Disclosure

I will inform Krystyna Kidson or associated staff or facilitators of any medical or mental health conditions, or pregnancy, that may affect my participation in the program.

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4.2. Personal Property

I understand that I am responsible for the protection of my personal property and Krystyna Kidson is not liable for any loss or damage.

 

4.3. Assumption of Risk

I acknowledge that my participation in the CPR Coaching Program is at my own risk.

 

4.4. Non-Clinical or Diagnostic Service

I agree that the service provided is a psychological service but is not and is not intended to be clinical or diagnostic in nature, and does not replace professional therapy, professional supervision, or medical care.

 

4.5. Compliance with Instructions

I agree to follow all instructions and safety guidelines provided by the facilitator to reduce the risk of injury.

 

4.6. Health Consultation

I have consulted with, or will consult with, my relevant health practitioner to ensure that I am fit to participate in the program.

 

4.7. Emergency Contact

I will provide Krystyna Kidson with an emergency contact who can be reached in case of an emergency during my participation in the program.

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4.8. Confidentiality

I understand and agree that personal information disclosed during the program is confidential and should not be shared outside the program environment.

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4.9. Informed Consent

I acknowledge that I have been informed of the nature, potential benefits, and possible risks of the CPR Coaching Program, and I consent to participate.

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4.10. Feedback and Communication

I agree to communicate any concerns, discomfort, or adverse effects I experience during the program to the facilitator promptly.

 

4.11. Guarantees

I understand that Krystyna Kidson promises to provide coaching, training, and support, but does not guarantee specific outcomes or results from participating in the CPR Coaching Program.

 

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5. Release of Liability

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I hereby release and discharge CPR Coaching program and Krystyna Kidson, its facilitators, employees, and agents from any and all claims, demands, damages, or causes of action of any nature whatsoever, including claims of negligence, arising out of or in any way related to my participation in the CPR Coaching Program.

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6. Legal Advice

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I understand that it is recommended to seek independent legal advice before signing this waiver if I have any concerns about the terms or my participation in the program.

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By signing below (or otherwise indicating my agreement), I confirm that I have read, understood, and agree to the terms and conditions outlined in this waiver and release form.

 

Signature:

Date:

Name:

 

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If you are under the age of 18, this form must also be signed by a parent or guardian.

Guardian Signature:

Date:

Name: