Meditation and Mindfulness Course Waiver and Release of Liability Form
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www.theresilientactivist.org
Welcome to The Resilient Activist  
We are honored that you have elected to join The Resilient Activist (TRA) in a meditation or mindfulness program. Please read this document carefully and contact us if you have any questions or concerns before signing it.

You can reach us at info@theresilientactivist.org or call us at 816-919-3131.
 
Nothing is without risk and the journey into mindfulness is no exception. Mindfulness and meditation education, training, and practice are not substitutes for medical or mental health treatment. If you are working with a health professional, you are encouraged to speak with them about the advisability of incorporating mindfulness practices before engaging in any services with TRA. Although mindfulness can be a helpful compliment to treatment, adverse effects may arise in certain circumstances. In addition to creating opportunities for equanimity, relaxation and peace, these practices can lead to an acute awareness of unpleasant thoughts, intense emotions, or uncomfortable body sensations.

We want you to know in advance that difficult experiences can also be a part of a mindfulness practice. If you find yourself struggling with your experience during a program, you should discontinue the practice, do what you need to in order to care for yourself, and ask your guide for support.
 
Certain forms of yoga and meditation may produce a deep state of relaxation that can continue for many hours after the session ends. For example, after yoga nidra practice, some people find they may need to refrain from driving a vehicle immediately after a session until they feel fully alert and capable of responding to situations that may arise while driving. Ask your guide for assistance if you need help obtaining transportation home from an event.

Some of TRA’s classes include yoga and/or other forms of mindful movement. As with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. Above all else, you are encouraged to listen to and honor your body. If you experience any pain or discomfort during a program, you should immediately discontinue the activity and ask your guide for support.
 
Yoga/mindful movement may not be safe under certain medical conditions. You are encouraged to verify with your health provider that your health and physical condition will allow you to safely participate in your activities with TRA. You are expected to make your guide aware of any medical conditions, changes in your health, or any physical limitations before each meeting. In addition, if you are pregnant, become pregnant or are post-natal or post-surgical, you are expected to let your guide know and to acquire your physician's approval to participate.

Your Name *
Course Waiver and Release of Liability Agreement *
"I affirm that I alone am responsible to decide whether to practice mindfulness and that participation in The Resilient Activist’s events and activities is voluntary and at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against TRA, its guides, and the facilities in which we meet.  I expressly agree that this release shall be binding upon my heirs, executors, administrators and assigns. By signing this Waiver and Release of Liability, I acknowledge that I have read it in full and understand all of its terms. I execute it voluntarily with full knowledge of its significance."
Required
Recording and Video Release *
"I understand the the events within this course or program may be recorded and the recording may be made available to other participants in this course or program.  No part of the recordings will be made available to the public or to others other than the course instructor(s) and participants."
Required
Thank you for your signature. This form is valid for one year from the original signing date.
We look forward to seeing you at future events!
Gratitude to the Midwest Alliance for Mindfulness for the template for this waiver.
A copy of your responses will be emailed to the address you provided.
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