STATEMENT OF INTENT AND RELEASE FORM
Awakening With Epstein (A.W.E.)
Awakening with Epstein is an educational and experiential experience that explores the unbound energy in the field that connects us all.
I understand that the Awakening with Epstein experience is not a means of diagnosing, treating or offering advise concerning any condition – physically, emotionally, mentally, psychologically, or spiritually. The care offered is to initiate and nurture new states of awareness and life and are focused on future changes, rather than remedying the past. Through care it is intended that I will find more sustainable and supportive inner meaning. I understand that the objective of the experience is to enhance my resourcefulness as it relates to my somatic and spinal strategies, and the expression of the energetic fields within and around me and the wisdom and energy available to me.
I acknowledge that the care I will receive is not a licensed practice. This experience, nor any facilitator during it, including Donny Epstein, as mentioned above, will not diagnose or treat any physical, emotional, mental or spiritual symptom or condition. Although the facilitators may hold other licenses or degrees, in this environment they are not functioning in such a capacity.
I understand and agree that the experience will include physical contact between myself, Donny Epstein, other experience facilitators and possibly other experience participants. Any physical contact that I have with the before mentioned individuals, will be both voluntary and non-intrusive, and is for the non therapeutic and non palliative purpose of educating me in observation of my movement, energy sensation or breath and to create greater access to my organizing fields of consciousness and the actions for me to take consistent with this. My participation in this educational process and experience constitutes my agreement to this physical contact.
During the processes designed specifically for this experience, I may experience a varied selection of transformative and healing modalities. Any of these types of experiences in and of themselves may awaken physical and emotional feelings, or memories. It is understood that sometimes healing during the transformational process feels wonderful, or ecstatic, and sometimes it does not feel comfortable at all.
I grant my practitioner permission to release information concerning my Network and SRI Care to Donny Epstein for the purpose of preparing for my attendance at the experience. In consideration of my participation in the experience presented by EpiEnergetics Institute and its promoters, I hereby release Donny Epstein, EpiEnergetics Institute, their agents, assistants, volunteers and employees from any liability whatsoever related to my participation in the experience. I understand the information on this form and agree to participate in Awakening With Epstein with the intent described above.
I understand that portions of the experience may be recorded through photo, video and/or audio and I agree to allow Donny Epstein, Epstein Technologies, LLC, EpiEnergetics Institute, LLC, and its agents to use photos/video/audio taken of me for educational, commercial, marketing, and public relations purposes.
Any and all of the said reproductions are the exclusive property of Epstein Technologies, LLC and EpiEnergetics Institute, LLC. Epstein Technologies, LLC is the exclusive copyright owner in perpetuity and all claims to such belong to Epstein Technologies, LLC. My signature grants permission to Donny Epstein, Epstein Technologies, LLC and EpiEnergetics Institute, LLC to use any of said reproductions in any responsible manner, including, but not limited to: publications, advertisements, educational materials, web sites, and/or commercial products. In consideration of my participation in this weekend EpiEnergetics educational and recording session with Donny Epstein, I hereby release Epstein Technologies, LLC, Donny Epstein, EpiEnergetics Institute, LLC, and their assistants, and employees from any liability related to my participation in this recorded educational experience.