Open Source Wellness, Inc. (“OSW”) provides a program which may involve movement, such as dancing or exercise, mindfulness, and meal suggestions (“the Program”), that is held virtually via teleconference and/or videoconference.

I understand that:
● The Program has not been licensed by the state and is not governed by HIPAA;
● The Program is complementary to healing arts services licensed by the state;
● OSW may contact me by phone, text message, or email;
● Photography and video or audio recording may occur for Open Source Wellness's marketing purposes, and I allow this use.
● Activities outside of the Program are independent of Open Source Wellness, even if I attend them with participants or staff of Open Source Wellness.
● OSWx is a peer-managed, peer-run community event that is not overseen by Open Source Wellness. As such, Open Source Wellness is not liable for OSWx.

STATEMENT OF FITNESS: I understand that it is my responsibility to meet with a doctor before taking part in the Program. I have either done that or, if not, I assume all responsibility for taking part in the Program without meeting with a doctor. I am in proper physical, mental and emotional condition and do not have any conditions which would increase my risk to illness or injury and I will let OSW know if that changes in future. I understand my physical limitations and am self-aware enough to stop physical activity before I become ill or injured.

ASSUMPTION OF RISK: I understand that there is a risk when joining any exercise class, including the Program, that I may become injured while exercising. I acknowledge the Program is not intended to be psychotherapy or medical therapy or a substitute for either one. OSW Trainers are not acting as licensed psychiatrists or psychologists. OSW trainers and volunteers have a wide range of education and experience, and are not acting based on any license, credential, or educational program. The content of the Program is based upon the understanding that physical movement, healthy food, social support, and stress reduction are helpful for a wide range of people. I understand the risks and dangers involved in the Program and I assume full responsibility for injuries and damages I experience as a result of my taking part in the program.

WAIVER OF LIABILITY: I HEREBY FULLY AND FOREVER DISCHARGE AND RELEASE OPEN SOURCE WELLNESS AND EACH OF THERE INSTRUCTORS, AFFILIATES, OFFICERS, DIRECTORS, ADVERTISING AND PROMOTIONAL AGENCIES, EMPLOYEES AND AGENTS FROM ANY AND ALL LIABILITY, CLAIMS, DEMANDS, ACTIONS AND CAUSES OF ACTION WHATSOEVER ARISING OUT OF ANY DAMAGES, BOTH IN LAW AND EQUITY, IN ANY WAY RESULTING FROM PERSONAL, PHYSICAL, PSYCHOLOGICAL OR EMOTIONAL INJURIES, DISTRESS, OR DEATH SUSTAINED THAT I MAY CLAIM OUT OF THE PROGRAM OR ANY OF ITS ASSOCIATED ACTIVITIES OR ARISING OUT OF OR CONNECTED TO THE LOCATION, FACILITIES, OR EQUIPMENT ASSOCIATED WITH THE PROGRAM. WAIVER OF LIABILITY IN THIS PROVISION INCLUDES LOSS, DAMAGE OR INJURY RESULTING FROM THE NEGLIGENCE OF OPEN SOURCE WELLNESS OR ITS PROGRAM PARTICIPANTS OR FROM ANY OTHER CAUSE OR CAUSES.

If any part of this agreement is found to be unlawful, void, or for any reason unenforceable, then that part will be removed, but this will not affect the validity and enforceability of any of the remaining parts of this agreement.

I understand this Agreement will be governed by the laws of the State of California, and that it cannot be changed unless in writing and signed by both parties.

I HAVE CAREFULLY READ THIS AGREEMENT AND I UNDERSTAND ITS CONTENTS. BY TYPING MY NAME BELOW I AM ELECTRONICALLY SIGNING THIS FORM, AND I CERTIFY THAT I AM 18 YEARS OF AGE OR OLDER, THAT I TAKE FULL RESPONSIBILITY FOR THE CARE, SAFETY, AND BEHAVIOR OF ANY MINORS THAT I BRING WITH ME, AND THAT ANY QUESTION OR CONCERN I HAVE OR HAD ABOUT THIS EVENT OR THIS AGREEMENT HAS BEEN ANSWERED TO MY SATISFACTION AND I ENTER THIS EVENT AND AGREEMENT FREELY AND VOLUNTARILY.