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SOUND THERAPY EVENT

LIABILITY WAIVER FORM

At Love & Sound Therapies, we prioritise the safety, wellbeing, and comfort of all participants. Completion of this Sound Therapy Liability Waiver Form is required prior to participation.

Signature Date *

This waiver will be valid for 12 months.

First Name *

Last Name *

Phone *

Email *

Kindly state if you are currently pregnant. *

Yes

N/A (Not Applicable)

Please list any medical conditions or injuries. Kindly type "NONE" if none.

Medical Contraindications & Health Status

Sound therapy sessions involve vibrational frequencies produced by instruments such as gongs, singing bowls, tuning forks, chimes, and other sound-based tools.

While sound therapy is generally gentle and restorative, it may not be suitable for individuals with:

Pacemakers or implanted electronic medical devices
Epilepsy or seizure disorders
Severe psychiatric conditions (including psychosis or paranoia)
Bipolar disorder (if unmanaged)
Severe anxiety or panic disorders
Recent surgery or acute injury
Pregnancy (please notify the facilitator for appropriate modifications)
Anyone taking heavy medication affecting nervous system regulation

If unsure, you are advised to consult a medical practitioner prior to participation and speak with the facilitator before the session.

This list is not exhaustive. If you have any condition not listed, it is your responsibility to seek professional medical advice.

Sensory Awareness & Personal Responsibility

I understand that sound therapy may produce physical, emotional, or sensory responses including deep relaxation, emotional release, lightheadedness, tingling, or temporary discomfort.

I acknowledge that I am responsible for listening to my body and may adjust my position, sit up, step outside, or discontinue participation at any time.

Somatic Touch & Physical Adjustments (If Applicable)

Some sessions may involve optional, respectful somatic touch or physical adjustments (such as grounding touch, blanket placement, or assistance with props).

I understand that:

Touch is never mandatory
Consent will be checked
My boundaries will be respected
Consent may be withdrawn at any time

Warranty of Health

I warrant that I am physically, mentally, emotionally, and psychologically able to participate in sound therapy sessions.

I understand that if I am not in suitable health, I may be advised not to participate or to modify my involvement.

Scope of Practice

I acknowledge that the facilitator is not a medical or mental health professional. Sound therapy is offered as a complementary wellness practice and is not intended to diagnose, treat, cure, or prevent any medical or psychological condition.

Assumption of Risk & Release of Liability

I voluntarily participate in sound therapy sessions at Love & Sound Therapies, understanding all associated risks.

I release Love & Sound Therapies, its facilitators, assistants, and affiliates from any liability, claims, or damages arising from participation and accept full financial responsibility for any related medical or therapeutic care.

Media & Recording Consent

I understand that media may be captured during sessions and used respectfully for promotional or educational purposes.

If I do not wish to appear in any media, I will notify the facilitator prior to the session.

Acknowledgement of Understanding

I confirm that I have read, understood, and voluntarily agree to the terms of this waiver.

Governing Law

This agreement is governed by the laws of Queensland, Australia.

By checking this box, I acknowledge and agree to the following: Medical Safety: I have reviewed the medical contraindications and that I am in suitable health to participate. Personal Responsibility: I accept full responsibility for my physical and emotional well-being during the session. Liability Release: I release Love & Sound Therapies from any claims or damages arising from my participation. Somatic Touch & Media: I understand that touch is optional and consent-based, and that media may be captured for promotional use unless I notify the facilitator otherwise. Governing Law: I agree that this waiver is governed by the laws of Queensland, Australia. I confirm that I have read, understood, and voluntarily agree to all the Terms and Conditions listed above. *

Yes

EmergencyContactFirstname

EmergencyContactPhone

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