top of page

Class Waiver and Release Form

Stillmind Wellness Center – Class Waiver and Release Form

Acknowledgment and Assumption of Risk

At Stillmind Wellness Center, we are committed to creating a peaceful, supportive, and welcoming environment where individuals can relax, reconnect, and nurture their overall well-being.

Your safety, comfort, and personal boundaries are important to us. Please read and complete this agreement before participating in any wellness activities.

1. ACKNOWLEDGMENT AND ASSUMPTION OF RISK

I acknowledge that I am voluntarily participating in wellness activities offered by Stillmind Wellness Center, located in Orange, California.

These activities may include, but are not limited to:

  • Meditation and guided visualization

  • Sound baths and sound healing experiences

  • Yoga, stretching, and gentle movement

  • Breathwork and relaxation exercises

  • Reiki and energy-based wellness practices

  • Mindfulness workshops and wellness events

  • Private and group wellness sessions

  • Other related wellness activities

I understand that participation in these activities may involve certain inherent risks, including physical discomfort, muscle strain, dizziness, changes in breathing patterns, emotional responses, sensitivity to sound or vibration, or other unexpected reactions.

I voluntarily assume the inherent risks associated with participation, including the possibility of personal injury or illness.

2. HEALTH AND PERSONAL RESPONSIBILITY

I understand that Stillmind Wellness Center offers wellness and relaxation services intended to support general well-being.

These services are not a substitute for professional medical care, psychological treatment, or medical diagnosis.

I acknowledge and agree that:

  • I am responsible for determining whether I am physically and emotionally able to participate.

  • I will consult a qualified healthcare professional before participating if I have medical concerns or conditions that may be affected by the activities.

  • I will inform the facilitator of any relevant health conditions, injuries, recent surgeries, pregnancy-related concerns, respiratory difficulties, or sensitivities that may affect my participation.

  • I understand that certain sounds, vibrations, breathing techniques, or physical movements may not be appropriate for everyone.

  • I may modify, decline, pause, or discontinue any activity at any time.

  • I am responsible for communicating discomfort or concerns to the facilitator.

I understand that participation is entirely voluntary and that I am encouraged to honor my body's individual needs and limitations.

3. RELEASE OF LIABILITY AND WAIVER OF CLAIMS

PLEASE READ CAREFULLY. THIS SECTION AFFECTS YOUR LEGAL RIGHTS.

To the fullest extent permitted by California law, I voluntarily release and discharge Stillmind Wellness Center, its owner, employees, instructors, facilitators, contractors, and representatives from claims arising from personal injury, illness, property damage, or other loss resulting from my participation in wellness activities, including claims caused by the ordinary negligence of the released parties.

I understand that this release applies to activities conducted at Stillmind Wellness Center and to Stillmind-facilitated activities at other locations.

This release does not apply to gross negligence, recklessness, intentional misconduct, or any other liability that cannot legally be waived under California law.

I understand that I am agreeing to this release voluntarily and that I have had the opportunity to read and understand its terms before signing.

4. PERSONAL BELONGINGS

I understand that Stillmind Wellness Center is not responsible for lost, stolen, or damaged personal belongings, except to the extent liability cannot be excluded under applicable law.

I am encouraged to keep valuables secure and bring only necessary personal items into the studio.

5. RESPECTFUL PARTICIPATION AND PERSONAL BOUNDARIES

Stillmind Wellness Center strives to maintain a peaceful, inclusive, and respectful environment.

I agree to:

  • Respect the personal space and boundaries of other participants.

  • Follow reasonable safety instructions provided by the facilitator.

  • Notify the facilitator if I feel unwell or uncomfortable.

  • Respect the privacy and confidentiality of fellow participants.

  • Refrain from photographing, recording, or sharing images of other participants without their permission.

I understand that I may decline physical adjustments, hands-on assistance, or participation in any activity that does not feel appropriate for me.

6. EMERGENCY MEDICAL ASSISTANCE

In the event of a medical emergency, I authorize Stillmind Wellness Center personnel to contact emergency medical services when reasonably necessary.

I understand that Stillmind Wellness Center does not provide medical treatment and that I am responsible for costs associated with emergency medical care or transportation.


  1. Media Release (Optional) From time to time, Stillmind Wellness Center may photograph or record portions of classes, workshops, sound baths, and special events.

These images or recordings may be used to share the Stillmind experience with our community through:

  • Stillmind Wellness Center's website

  • Instagram, Facebook, and other social media platforms

  • Eventbrite and event promotions

  • Digital advertisements and marketing materials

  • Newsletters, brochures, and other promotional publications

Please select ONE option below:

OPTION 1: YES, I GIVE PERMISSION

I understand that photos and videos may occasionally be taken during classes and events for promotional purposes.

☐ I grant permission for my image to be used in marketing materials, social media, or website content.

☐ I do not grant permission for my image to be used.


Additional Privacy Acknowledgment

I understand that photographs or recordings shared publicly may be viewed, downloaded, or redistributed by others outside Stillmind Wellness Center's control.

I may withdraw my photo and video consent for future use at any time by notifying Stillmind Wellness Center in writing. Withdrawal will not necessarily affect materials already published, distributed, or used before the request was received. COVID-19 / Communicable Disease Acknowledgment

I acknowledge that participation in in-person classes may expose me to illness. I voluntarily assume full responsibility for any risk of illness or injury arising from my participation.

8. ACKNOWLEDGMENT AND AGREEMENT

By signing below, I acknowledge that:

  • I have carefully read and understand this Participant Liability Waiver and Release of Liability.

  • I understand the potential risks associated with participating in wellness activities.

  • I voluntarily choose to participate and accept the responsibilities described in this agreement.

  • I understand that I am releasing certain legal rights, including claims arising from ordinary negligence, to the extent permitted by California law.

  • I have independently selected my preference regarding photography and video recording.

  • I understand that photo and video consent is optional and is not required for participation.

  • I am at least 18 years of age and legally authorized to sign this agreement.

I understand and agree that this waiver applies to my current and future participation in Stillmind Wellness Center activities unless superseded by a new agreement or otherwise required by law.

By entering your name, you are signing the document.

Are you 18 years and older?
Yes
No

CONTACT US

phyllis (@) still-mind.com

650.548.9597

2323 N. Tustin Avenue

Suite I-2
Santa Ana, CA 92705

Start Your Journey to Calm

Ready to feel more grounded? Join me for 10 Days to Calm and discover simple practices to bring peace into your daily life.

© 2026 by stillmind™

All Rights Reserved. 

bottom of page