As a condition to my participation in health coaching (the "Program") with Jennifer Stump DBA The Sprouted Life (the "Coach"), I agree as follows:
1. I do hereby waive, release, and forever discharge the Coach, and their independent contractors, employees, representatives, and all others from any and all responsibility or liability for injuries or damages resulting from my engagement in any activities, including, but not limited to dietary changes, exercise, and stress management, arising out of my participation in any activities under "health coaching".
2. I understand that the Coach is not a licensed dietitians, naturopathic doctor, physician or other medical professional. I further understand that coaching does not replace seeing a licensed physician or other medical professional. I acknowledge and agree that:
4. I further acknowledge that I have either had a physical examination and have been given a physician’s permission to participate or that I have decided to participate in physical activity and/or use of exercise equipment without the approval of my physician and do hereby assume all responsibility and risks of injury from such participation and activities.
5. Personal Responsibility, Disclaimer & Release of Claims.
7. I am aware that health coaching will take place either over the phone or through video teleconferencing at a day and time that is mutually agreed upon.
8. I understand that I am expected to make all calls/appointments on time.
9. Health Coaching Process: Coaching is a collaborative process that requires active and invested participation. To get the maximum benefit from coaching, I should come to each coaching session prepared with a topic for discussion. Successful health coaching is largely dependent on my willingness to define and accept goals and try new approaches. I will determine the goals and outcomes and I will have the ultimate responsibility for the choices, plans, timing and actions that I decide to take.
10. Confidentiality: The Coach will keep all information exchanged between me and my Coach during the Program confidential. The Coach will not disclose any information that I share during the Program to anyone else unless: (1) such person has a legitimate reason to know such information as a member of the Coach's team or staff, (2) such disclosure is required by law, (3) I have given my Coach prior written permission, (4) such information is already known to the Coach or another members of their staff, (5) such information is acquired from a third party or (6) such information is or becomes generally known to the public other than as a result of disclosure by the Coach or another member of their staff.
I have read the above consent, waiver and release and fully understand its contents and voluntarily agree to the terms and conditions stated. I acknowledge that I have reviewed (or have had the opportunity to review) all aspects of this Agreement with my counsel. I acknowledge that agreeing to the terms of this Agreement is a condition precedent to my participation in the Program. I further acknowledge that I take full responsibility for my life and well-being, and all decisions made during and after this Program.