Auto-Debit Note: The first auto-debit payment amount is $80 to cover the full cost of the first session/month; subsequent payments are $40 per month.

PLAN/MEMBERSHIP AGREEMENT

This High-Vibe Membership Agreement is between Adriena Dame (DBA High-Vibe Living) and Client/Member for private healing arts sessions, services, and group classes in exchange for a monthly or annual membership fee. 

 

Duration, Automatic Renewal & Autopay

This Agreement begins upon payment of the first membership fee. All membership options require automatic payment, and have a 3-month minimum commitment. Once the 3-month commitment has been completed, automatic payment will continue on a month-to-month schedule without disturbance until the Client or High-Vibe Representative cancels. Payments subsequent to the initial payment may be processed on the first day of the month.

 

Membership Cancellation

In the event that the Member wants to discontinue membership/auto-pay, they are required to inform High-Vibe Living via email (highvibeliving.org@gmail.com) at least 2 weeks in advance of the next billing date. 

 

Payment Terms

Client agrees to pay Adriena Dame/High-Vibe Living monthly recurring membership fees as follows: 

* Member-authorized automatic credit/debit card or checking account ACH charges; 

* Each client payment is $80;

* Client is charged monthly until account is cancelled, with a minimum 3-month commitment;

 

Insufficient Funds 

There is a $20 insufficient funds fee on any Autopay that is declined/returned to High-Vibe Living via the member's Financial Institution.

 

Liability Waiver and Release
I am here to inspire my own personal holistic health, wellness, and transformation. With a deep and abiding respect for myself, I take full responsibility for my well-being and any choices I make about how I move, breathe, inhabit stillness, receive non-invasive healing therapies (i.e. Tibetan Acupressure, massage, energy healing . . . ). My heirs, guardians, legal representatives, and I hereby and forever release, waive, and discharge any and all claims against the School of High-Vibe Living (High-Vibe Living or DBA alias), its teachers, practitioners, volunteers, and participating affiliates.


I have read this a Liability and Release Waiver in its entirety, understand its contents, and am aware that (1) at no time is High-Vibe Living or its affiliates responsible for any injuries or other damage that may occur as a result of my voluntary participation in their services at any and all locations/venues, including in-home visits, (2) this waiver and release of potential liability is a legally binding contract between High-Vibe Living and myself.

Photo/Video Release
I hereby authorize High-Vibe Living to publish photographs and/or video of myself captured during any as event in which I am a participant for use in print, online and video-based marketing materials, as well as other professional publications.


I further acknowledge that my participation in High-Vibe Living events is voluntary and that I will not receive financial compensation of any kind in associated with the taking or publication of these photographs/video or participation in company marketing materials or other publications. I acknowledge and agree that publication of said photos/videos confers no rights of ownership or royalties whatsoever.
 
I hereby release High-Vibe Living, affiliated contractors, employees and any third parties involved in the creation or publication of High-Vibe Living publications, from liability for any claims by me or any third party in connection with my participation.

 

Permission to Treat
I hereby consent to private healing/bodywork sessions as offered by professional practitioners at High-Vibe Living. I understand that methods of treatment may include, but are not limited to: energy balancing and harmonization, biofield therapies, Reiki, medical intuition, chakra harmonizations, past life exploration, Shamanic journeying, meditation, visualizations, spiritual counseling, spirit communication, yoga, Ayurveda, Emotional Freedom Techniques, Tibetan Acupressure, massage therapy, aroma therapy, earth magic, psychic mediumship, spiritual/energy cleanses and more. I will immediately notify my practitioner of any unanticipated or unpleasant effects associated with any of the energy and/or bodywork modalities applied.

I have been informed that energy medicine is a generally safe method of treatment, but that shifts in energy may create some physical, emotional or spiritual side effects which may include physical tingling, feeling lighter energetically, mild fatigue, nausea, muscle soreness, headache, thirst, changes in relationships, shifts of perception, etc. I do not expect the energy practitioner to be able to anticipate and explain all possible risks and complications of energy treatment, and I wish to rely on the energy practitioner to exercise judgment during the course of treatment which the energy practitioner exercises a best and highest interest for healing, based upon the facts then known and for my best interest and highest good. I understand that results are not guaranteed.

I understand that all clinical information and records of energy healing treatments, etc., will be kept confidential and will not be released without my written consent.

By submitting this agreement, I am acknowledging that I have read, or have had read to me, the above consent to treatment, have been told about the risks and benefits of energy medicine and intuitive energy healing and other energy and bodywork modalities, and have had an opportunity to ask questions. I intend this consent form to cover the entire course of my energy/bodywork treatments for my present condition and for any future conditions(s) for which I seek healing/coaching. I also understand and acknowledge that this agreement is binding and that my electronic submission of this agreement can serve as my signature.  

 

Signature

I have carefully read this agreement and fully understand its content. I am aware that I am entering into this Plan/Membership Agreement with High-Vibe Living. I also understand and acknowledge that this agreement is binding and that my electronic submission of this agreement, and my payment, are to serve as my signature.

90-Minute Bi-Monthly Self-Care Plan: $80

90-Minute Bi-Monthly Self-Care Plan: $80

HighVibe Living

4169 Westport Road #120 

Louisville, KY 40207

By appointment only.

© 2020 HighVibe Living LLC

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