Inner Light Astrology Agreement and Release Form

Astrological readings are intended for educational and/or entertainment purposes only, and are not to be considered as a replacement or substitute for medical, legal, mental health or other counseling services. With this understanding, and of my own free will, and being of sound mind, I agree to have Debra Bloom, dba Inner Light Astrology, read my / my child’s  chart for a fee in the amount agreed upon below, payable in advance. I further agree that I will not bring any legal and/or financial claims against Debra Bloom and/or Inner Light Astrology that may result from the service(s) she performed as stated above. My signature constitutes a full and final release of Debra Bloom and Inner Light Astrology from any and all liability including any and all claims brought by my successors and/or assigns.


Email *
Name *
Provide your first and last name if the reading is for you.
Child
If this reading is for your child, please provide your child's first and last name.
Fee *
Please include the agreed upon fee as discussed with Debra Bloom.
Signature *
This electronic signature indicates your agreement and release of liability.
Date *
MM
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DD
/
YYYY
*This release applies only to the client and/or a minor child. If the reading is purchased for another adult client, then that client must sign their own release. Under the law, the purchaser cannot waive the rights of another person of the age of majority.
A copy of your responses will be emailed to .
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