STATEMENT OF INTENT AND RELEASE FORM

ULTIMATUM

ULTIMATUM: The Journey For A New Humanity (herein referred to as ULTIMATUM) is a unique experience delivered by Donny Epstein. During this experience you will receive and participate in a transformative experience designed to change and evolve your life strategies, connection to yourself and others, as well as your commitment to the fullest expression of your life. As part of this experience, you will receive and participate in Donny Epstein’s most advanced transformational technologies, which will assist you to experience and remember with greater depth and knowing, the effortlessness of your authentic nature and awaken you to your sphere of participation in the world.

This experience is an energetic educational experience. In this experience, you will be guided on a journey of learning how energy – in your body and around you – influences how and why you live life in the way you do, and how conscious actions can redirect your life experience in congruence with your unique energetic make-up. This journey goes through three specific sites: Discover, Transform, and Awaken. It is a journey, which commences as one discovers the manner in which one has learned to defend oneself against the awakened self. The individual is then led to a new level of discovery, which can further his/her personal emergence and actualization. It is about how a person experiences and expresses one’s unique nature. As the person moves through this journey, he/she learns to experience him/herself acting in the world, empowered enough to access the fuel and wisdom stored as his/her own energy: bio-energy, emotional energy, mental energy, personal soul energy, and universal soul energy. By learning how one uses these many levels of energy, the ability to awaken to extraordinary energetic access becomes possible. This leads to the open self, where the individual becomes ready to embrace life as service, to transform to new levels, and to embody spirit with greater depth.

During the experience, Donny Epstein may work with you to help develop your unique Energetic Constitution. This fundamental determination of who one is, is one’s individual energetic makeup. This manifests as how one is in the world, what one feels, how one acts, and most especially how one holds one’s body, one’s consciousness, and one’s energy. This is determined on several levels and culminates in a detailed assessment of one’s constitutional type. This is different than personality type, body type, blood type, or other ‘types’ or ways that have been developed to categorize individual styles, and makeup. It is totally novel in approach, assessment, and methodology.

ULTIMATUM provides education and coaching/sponsoring to develop new strategies for accessing these fields of consciousness and for the physical experience of and utilization of their wisdom. Our intention with this education and sponsoring is to support you in improving your self-observation and self-regulation. All people deserve a life of enriched wellness, resourcefulness and inner knowing. ULTIMATUM seeks to help you live a life of greater inner strength, love, capacities, creativity, attentiveness, wellness and enjoyment. ULTIMATUM will assist you in recognizing the inner wisdom or magic available to you in each moment.

I understand that this is an Energetic Educational Seminar, from which I may experience a greater connection with my inner wisdom. One particular spiritual path or model is not stressed as being more valid then others, and different models may be presented during separate experiences.

I understand that ULTIMATUM 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 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.

So that the work together during the experience can develop and flow freely, I understand and agree that my participation in ULTIMATUM does not grant me authority to teach, instruct or perform the experience material in any public or commercial capacity without express permission from Donald Epstein, Epstein Institute or its appointed organizations. I should treat everything taught during this experience as proprietary information. My participation in ULTIMATUM represents my agreement to these conditions.

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 ULTIMATUM with the intent described above.

I understand and agree that personal recordings Donny Epstein created for each participant of ULTIMATUM can be shared with Donny Epstein’s research and development team and can be used to further advance and research the technologies Donald Epstein has created so far and which are part of this experience. The information will be exclusively used for research and development purposes.

Any physical contact during the session will be both voluntary and non-intrusive. The intent of the session is non-therapeutic and non-palliative, and solely for the purpose of educating me in observation of my or others movement, energy, sensation, breath and to create greater access to the organizing fields of consciousness. My participation in this educational process and experience constitutes my agreement to this conversation and contact.

I understand, acknowledge and accept that I, and others in attendance, will be recorded through photo, video and/or audio. 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. 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.