Welcome! I am delighted to host you for a Personal Nourishment Retreat in Carlsbad, California at my healing studio.
I request that you participate in only those activities that you are physically, mentally, emotionally, and spiritually able to do, and that you notify me of any restrictions you have regarding any of the activities, and I will do my best to accommodate them. Your safety and comfort is of the utmost importance to me.
Please read the following information carefully and let us know if you have any questions before signing and agreeing to this.
RETREAT PAYMENT
Registration payment is non-refundable and possibly transferrable in special circumstances as determined on a case by case basis.
We reserve the right to decline attendance and refund registration fee to any individual we deem an inappropriate fit for this experience.
RELEASE AND WAIVER
I voluntarily desire to participate in the Personal Nourishment Retreat Experience (“Experience”) organized by Keri Nola of Path to Growth, LLC (the “Facilitator”). I understand that the Experience will involve an in-person, healing experience, including possible body work, aerial somatic therapy and pre-event and post-event coaching/mentoring/intuitive sessions via phone or video for the purposes of facilitating personal/professional growth, healing and transformation experiences using holistic methods. In exchange for participation in the Experience and/or use of the property, facilities, meals and services provided during the Experience, I agree to the following:
I take full and sole responsibility for my life, business, well-being and all decisions made before, during and after the Experience.
I acknowledge that I am choosing to participate voluntarily in various activities at the Experience and I recognize that these activities may contain certain inherent risks. These activities may include, but are not limited to: arts and crafts (creativity), group discussions, meditation, breathing exercises, guided imagery, spiritual work, journaling, dance/movement practice, aerial somatic therapy, nature activities, beach visits, swimming, meditative walks, physical activities, aromatherapy, energy work, massage, body work, chiropractic care, appropriate physical contact for the purposes of facilitating healing, intuitive readings, and other activities provided by the Facilitator/s, Event Sponsors, or others (collectively “Program Activities”).
I expressly assume the risks of the Experience and all Program Activities. I understand that I am responsible for my own transportation to/from the Experience, including any transportation during the Experience, and that all transportation is at my own risk and liability, even if the Facilitators provide suggestions, recommendations, discounts or offers related to transportation, hotels, and/or other accommodations.
I agree to observe and obey all posted and announced rules and warnings, and further agree to follow any instructions or directions given by the Facilitators, or their employees, representatives or agents. Specifically, I agree to refrain from consuming any alcohol or drugs of any kind during the duration of the Experience at any time, unless prescribed by a medical or mental health practitioner and consumed appropriately in accordance with the prescription dosage.
I understand that the information provided at or in conjunction with the Program Activities and Experience is not intended to be a substitute for professional medical advice, diagnosis or treatment that can be provided by my own physician, therapist, licensed dietitian or nutritionist, or any other licensed or registered mental or physical health care professional. I understand that the Facilitator/s and their employees, representatives and agents are not acting in any capacity as a medical or mental health care provider, unless you are currently in an established therapeutic relationship with Keri Nola which is bound by informed consent. I understand that they are not providing health care, medical or nutrition therapy services or attempting to diagnose, treat or cure in any manner whatsoever any disease, condition or other physical or mental ailment of the human body during the course of the Retreat. Rather, they are serving in their capacities as Facilitators, coaches, mentors and guides, unless you are currently in an established therapeutic relationship with Keri Nola which is bound by informed consent.
I understand that I may be provided with meals, snacks, and other products or services provided by or through the Facilitators, Event Sponsors or others while at the Experience and I agree to disclose to the Facilitators in advance any known or suspected food allergies or sensitivities, any physical limitations that may impact my breathing or movement, or any other health or mental condition that may be affected during the Experience. If I suspect that I have a medical or mental health problem, I agree to inform the Facilitators and their agents immediately.
I agree to seek the advice of my physician or another qualified health care professional prior to and during the Experience regarding any questions or concerns I have about my specific health situation, possible or actual pregnancy, known or suspected food sensitivities or allergies, dietary restrictions, or any medications I am currently taking. I understand that I am advised to speak with my own physician or mental health provider before attending the Experience or implementing any Program Activities. I agree to not disregard or delay seeking professional medical advice or stop taking any medications without speaking to my own physician or mental health care professional.
At any time before or during the Experience, should I know or feel that I may cause imminent harm to myself, other participants, the Facilitators, or any other person, I understand and agree that I am immediately obligated to let the Facilitators know, and to remove myself from the situation in a peaceful and cooperative manner; otherwise, I consent that I may be asked to not attend the Experience, leave the Experience, and/or have immediate physical or mental health care administered to avoid causing mental or physical harm to myself or others.
I consent to the application of first-aid or other medical or mental health services to be applied if needed in connection with an emergency health problem or potentially harmful situation during the Experience, and I agree to hold the Facilitators harmless as a result of any such injury or damage I may suffer due to the application of medical or mental health services or treatment. I also agree and consent that the Facilitators may contact my Emergency Contact as shown on the bottom of this form if they deem it necessary.
I release the Facilitators and Event Sponsors from any and all liability, damages, causes of action, allegations, suits, sums of money, claims and demands whatsoever, in law or equity, which I have ever had, now have or will have in the future against the Facilitators or Event Sponsors, arising from my past or future participation in, or otherwise with respect to, anything related to and including the Experience, including transportation to, from and during the Experience, unless arising from the gross negligence of the Facilitators.
In no event will the Facilitators or Event Sponsors be liable to any party for any direct, indirect, special, incidental or consequential damages for any use of, non-use, or reliance on this Experience, its information, programs, meals/snacks/food, products and/or services, including, without limitation, personal injuries, accidents, misapplication of information, or any other loss, malady, disease or difficulty, or otherwise, even if I am expressly advised of the possibility of such damages or difficulties, whether caused by the fault of myself, the Facilitators, Event Sponsors, other attendees or other third parties. I agree to pay for all damages to the facilities caused by any negligent, reckless, or willful action that I may take.
By participating in this Experience, I consent to photographs, videos, and/or audio recordings that may be made that may contain me, my voice and/or my likeness. I understand that I release all rights and you reserve full rights to use these photographs, videos, and or/audio recordings and/or any other materials submitted by me to you in connection with my participation in the Experience in any way related to your business and/or your current or future marketing or promotional efforts, without compensation to me at any time, now or at any time in the future.
Any dispute concerning this release, the Facilitators or any aspect of my participation in the Experience or Program Activities shall be governed by the laws of the State of California and brought in the state or federal courts of California.
I have carefully read this document and by checking the agreement box I consent to all parts of it. I understand that by checking the agreement box, I voluntarily surrender certain legal rights.
Aerial Somatic Therapy may be a part of your experience if you choose and below is specific information about this modality and it's risks and benefits for your consent.
I am looking forward to co-creating a beautifully sacred experience together in honor of your wholeness and alignment. Please read this below information carefully as it will share important information about this body of work you will be experiencing, including providing intentional disclaimers to ensure you are choosing to participate in Aerial Somatics from a place of sovereignty.
What is Aerial Somatics?
Aerial Somatics is a mind-body-soul integration modality and is a process of integration aiming to create a sense of wholeness and alignment. This alignment can lead to improved mental and emotional well-being, physical health, a sense of inner peace, and a deeper connection to one’s life purpose and the Divine.
The central tool for the Aerial Somatics modality is a “somatic swing,” utilized by an entrained healing arts practitioner to facilitate transformational healing and nervous system regulation including deeper connection to self/other and optimal health and functioning. The somatic swing is utilized to support the body, simulating a weightless womb-like experience allowing one to receive a transmission of safety and connection being held inside the cocoon of silk fabric. This opens the body system to natural unwinding of tension patterns revealing the spherical nature of reality. This unwinding of the fascia system clears stored pain, stress and distortion patterns creating an experience of liberation in body and mind.
This innovative multi-dimensional modality utilizes principles of directed focus, fluid feedback and regenerative alignment in relationship with the pillars of gravity, fluid dynamics, tensegrity and entrainment. The suspended somatic swing technology allows for the harnessing of gravity and the other pillar forces for optimal embodied integration.
In an Aerial Somatics transformational healing session, clients are taken through a strategic and intuitive process of unwinding tension patterns within structural layers (muscle, fascia, joints, bones) of the body to create a dilation of the internal fluid pathways.
This experience can provide profound relaxation, body awareness, emotional regulation, resourcing, grounding, nervous system regulation, relational/attachment healing and trauma resolution.
The Aerial Somatics somatic swing practices integrate the art and science of effective healing modalities including Cranial Sacral Therapy, Thai Massage, Acro Yoga Therapeutics, Structural Integration and Somatic Bodywork and I weave in my expertise in shadow work, inner child healing, breathwork, energy/frequency medicine and abundance activation as appropriate in each session.
Each session is unique and organically unfolds based on the energy of the moment.
Aerial Somatic work is slow, gentle, intentional and typically relaxing even though significant transformation is happening. It's not uncommon for there to be emotional release ranging from orgasmic bliss, to deep grief and/or sacred rage and it's also ok if you just feel content, neutral or possibly numb. Your body is wise and we honor it all.
Client Agreement
This Agreement is being made between Keri Nola of Path to Growth, LLC (Practitioner) and Client. We both legally agree to the following:
- Expectations and Responsibilities
You can expect that I will fulfill certain responsibilities during our work together. As the Pracitioner, I agree to:
- Be present with you during our scheduled time together.
- Guide and facilitate the Aerial Somatic Healing Experience
- Offer intuitive guidance, suggestions, facilitate healing processes and exercises aligned with your intentions.
- Hold compassionate space for your awakening.
Likewise, I expect that you will fulfill the following responsibilities during our time together. As the Client, you agree to:
- Show up on time (sessions will start and end promptly according to our appointment)
- Show up sober without the influence of alcohol, drugs or psychedelic substances for our session
- Show up willing to trust the process and practice receptivity and surrender to experience the most benefit from the session.
- Provide payment for each session before scheduled appointments.
- Be open to growing and stretching beyond your preferences and comfort zone.
- Be gentle and compassionate with yourself as transformation is underway.
- Ask any questions you may have as they arise and clearly communicate any unmet needs and make requests for change as needed during our session.
Confidentiality is important to me. I will do my best to keep all information exchanged between us during the Session private and confidential. I will not disclose any information that you share with me during the Session to anyone else unless: (1) they have a legitimate reason to know such information as a member of my team or staff, (2) you have given me written permission, (3) if I am required to do so by law, (4) in the good-faith belief that disclosure is necessary to conform to the law or to the legal process, (5) to protect or defend our rights or property, and/or to protect personal safety, (6) in the well intentioned use of examples for marketing or teaching in which case your name and identifying information will be protected and remain anonymous unless you have given me permission otherwise.
- Intellectual Property Rights.
Ownership of Program Content and Materials: I retain all ownership and intellectual property rights to the content and materials provided to you through the Sessions, including all copyrights and any trademarks belonging to me. Any content and materials are being provided for your individual use only and with a single-user license which means that you are not allowed or authorized to share, copy, sell, post, distribute, reproduce, duplicate, trade, resell, exploit, or otherwise disseminate any portion of the materials, electronically or otherwise, for business or commercial use, or in any other way that earns you money, without my prior written permission. No license to sell or distribute my content and materials is granted or implied. No permission to disclose my process as expressed through the content and materials is granted or implied.
Intellectual Property Rights in Work Product: You hold all intellectual property rights in your work product developed during your participation in the sessions, including but not limited to copyright and trademark rights. I agree not to claim any such ownership in your work product or intellectual property at any time.
- Personal Responsibility, Disclaimer & Release of Claims.
Personal Responsibility & Assumption of Risk: You acknowledge that you take full responsibility for yourself and all choices, actions and results made before, during and after your Session/s. While every effort has been made to create the safest experience for you, you understand that there may be some risks associated with the Session/s. While Aerial Somatics (Session/s) are generally gentle and safe, you are responsible for participating mindfully and responsibly.
You knowingly assume all of the risks of the session/s related to your participation and use, misuse, or non-use of any related content or materials. You agree to be mindful of your own well-being during the course of the session/s, and you understand and agree that you are solely responsible for your results.
Disclaimer: While I have been licensed in the state of Florida to practice as a psychotherapist, my license is currently in retired status and at no time does our session/s provide psychotherapy. Further, participation in session/s does not enter you into client-patient relationship with me. I have used care in preparing for the experience/s I will facilitate for you, but this work and my materials are being provided as self-help tools for your own use and for informational and educational purposes only. There are many factors that influence results, so no guarantees can be made as to the results you will experience through this Session/s. You agree that I am not responsible for your physical, mental, emotional and spiritual health, for your financial earnings or losses, or for any other result or outcome that you may experience through this Session/s. Nothing related to this Session/s is intended to be considered medical, mental health, legal, financial, or religious advice, nor is it intended to replace the expertise, care, judgment or guidance of your own medical or mental health practitioners, clergy members, accountants, attorneys or financial advisors. It does not, nor is it intended to, provide medical nutrition therapy, psychotherapy, psychological counseling, behavioral health, or a personalized assessment of macronutrients or micronutrients. This Session/s shares general information, not necessarily personalized recommendations. It is not preventing, treating, curing any medical or mental health disease, condition or ailment. For specific questions related to a medical or mental health situation, consult your own medical or mental health professional. For specific questions related to your financial, legal or tax situation, consult your own attorney, accountant, and/or financial advisor. For specific questions related to religion, spirituality, or faith, consult your own clergy member or spiritual healer. If you are currently under the care of a medical or mental health practitioner or currently uses prescription medications, do not make any dietary changes or start or stop taking any dietary supplements or medications because of anything you have read or received through this Session/s without first consulting with your doctor. Any recommendation of any product or supplement mentioned in or through this Session/s is offered for educational purposes, and you agree to check with your own medical professional before using any of these products or supplements on, in or near your body in any way. You understand that the statements, information, supplements or products provided in or through this Program have not been evaluated by the Food and Drug Administration (“FDA”).
Limitation of Liability, Indemnification, and Release of Claims:
You agree that if you believe the Services and/or the Premises are unsafe, you will immediately discontinue participation in such services and will leave the Premises.
You agree that the information included in this experience is not, nor should be, a substitute for personalized health care, medical, mental health, financial, legal or religious advice of any kind.
You acknowledge and understand that there are dangers, hazards and inherent risks involved with the Session/s to which you may be exposed, including the risk of serious physical injury, temporary or permanent disability, and death, as well as economic. The dangers, hazards and risks may arise from your own actions, inactions, or negligence as well as from the actions, inactions or negligence of others, including Keri Nola, or the condition of the Premises at which the Session/s are performed and/or provided. You also acknowledge and understand that there may be other dangers, hazards or risks not presently known or reasonably foreseeable.
You hereby expressly agree to assume all dangers, hazards and risks arising from your receipt of the Session/s and do hereby release, indemnify and hold harmless Keri Nola and Path to Growth, LLC. and our employees, independent contractors, agents, volunteers or assigns, from and against any and all liability, actions, debts, claims and demands of every kind whatsoever, specifically including, but not limited to, any claim for negligence or negligent acts or omissions and any present or future claim, loss or liability for injury to person or property that you may suffer that may or does arise out of the Services performed and/or provided.
You agree to hold me free of all liability and responsibility for any actions or results with actual or perceived adverse effects that you claim were created as a direct or indirect result of specific experience, information or recommendations that you have received through this Session/s.
Notice: All correspondence or notice required regarding the Session/s shall be made to me by e-mail at support@kerinola.com and to you at the e-mail address you provided during your enrollment in the Session/s. Should your e-mail address, billing information, or contact information change at any time throughout the Session/s, it is your responsibility to provide your updated information to me within 3 days of any change.
Force Majeure: In the event that any cause beyond my reasonable control, including, without limitations, “acts of God”/nature, war, curtailment or interruption of transportation facilities, threats or acts of terrorism, State Department travel advisories, labor strikes or civil disturbances, unforeseen or foreseen human-initiated circumstances, health or travel restrictions, quarantines, lockdowns or precautions imposed by any government entity or agency, local, state or federal law or ordinance, or other instances, make it inadvisable, illegal, or impossible for me to perform my responsibilities or obligations under this Agreement, either because of unreasonable increased costs or the risk of injury, I will not be liable for a reasonable period of delay or for the inability to indefinitely fulfill my responsibilities and obligations.
Entire Agreement, Assignment, Survivability, Enforceability and Waiver: This Agreement contains our entire agreement. This Agreement supercedes or replaces any prior oral or written agreement signed by us pertaining to the subject matter of this Agreement. This Agreement may be modified or amended at any time provided the amendment is in writing and signed by both of us. You may not assign your rights or obligations under this Agreement to anyone else, and the obligations under this Agreement shall survive indefinitely unless otherwise stated in this Agreement. If any section of this Agreement is found to be unenforceable, the rest of the document shall be held in full force and effect. If I choose to waive or not enforce one or more terms of this Agreement, it does not in any way limit my right to later enforce every part of this Agreement.
Governing Law: This Agreement shall be construed according to the laws of the State of California where my principal place of business is located.
Dispute Resolution: Should we ever have a conflict, it is hoped that we could work it out amiably. However, if we are unable to seek resolution through good-faith negotiation within 30 days, we agree now that that the only method of legal dispute resolution that will be used is binding arbitration before a single arbitrator, jointly selected by both of us, unless we both agree otherwise in writing or otherwise provided by law. You understand and agree now that the only monetary damages that can be awarded to you through arbitration is the full refund of your Payment made to date. No other financial awards of consequential damages, or any other type of damages, may be granted to you. We both agree now that the decision of the arbitrator is final and binding and may be entered as a judgment into any court having the appropriate jurisdiction. You also agree that should arbitration take place, it will be held in San Diego County in the State of California where my principal place of business is located, and the prevailing party shall be entitled to all reasonable attorneys’ fees and all costs necessary to enforce the decision of the arbitrator.
Mutual Non-Disparagement: Should you have any questions or concerns about the Session/s or me, you agree now to contact me directly in a mature and professional way rather than to publicly make any negative or critical comments about the Session/s, my business or me through social media or otherwise. We both agree now not to communicate with any other individual, company or entity in a way that is harmful or disparaging to the other, whether actual or perceptual, or to do or say anything that is injurious to each other’s reputation, including about the Program, me, my business, my employees, contractors or agents, other participants. In arbitration or when required by law, of course, we are not prohibited from publicly sharing our thoughts and opinions.
By signing this Agreement, we both acknowledge that we have read, understand, agree to and accept all of the terms in this Agreement. Electronic signatures of this Agreement are permitted and enforceable. You agree that you have had the opportunity to ask me any questions prior to signing, and your signature indicates that you are in agreement with all of the terms of this Agreement.