Mindful movement - indemnity form

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I'm looking forward to our time of mindful movement together. If you have any questions, please do feel free to reach out to me.

Cands

BA Psychology (Hons), C-HYI Trauma-Sensitive, C-HYI Therapy

Licensed Specialist Wellness Counselor (ASCHP, reg no: SWC20/617)
cands@candiceclark.co.za
candiceclark.co.za

Full name *

Email address *

I understand that mindful movement is not a substitute for medical attention, examination, diagnosis or treatment. Mindful movement is not recommended and is not safe under certain medical conditions (incl pregnancy). I affirm that I alone am responsible to decide whether to practice mindful movement. I hereby agree to irrevocably release and waive any claims that I may have now or hereafter, against Candice Clark. *

I understand that mindful movement includes physical movement as well as an opportunity for relaxation, stress and re-education and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious disabling or death, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, adjust the posture or ask for support from Candice Clark. *

Please print your name in the space provided below as agreement to all above-mentioned contractual terms and conditions. *

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