Somatic Plant Medicine Integration Student Release

I hereby agree to the following:

 I am participating in the Somatic Plant Medicine Integration Training (the “Training”) of my own will and volition and voluntarily agree to all the terms and conditions of this Informed Consent and Release Agreement (“Agreement”). I am not under the influence of alcohol or drugs at this time and am sufficiently qualified, trained, and capable to participate in the Training and all Released Activities.

 I understand and agree that I will be solely and exclusively liable for all my acts and omissions at all sessions, meetings, and consultations related to any Trainings, including, but not limited to, at a Training event, through my private practice, and at an unaffiliated location.

 I acknowledge and agree that the Training is the exclusive intellectual property of Atira Tan (the “Intellectual Property”). I further understand that Atira Tan is the exclusive owner or licensee of all materials utilized in the Training including, but not limited to, all printed, audio, video, digital, online, and other materials (“Materials”). The Materials also include all duplicates, reproductions, and derivatives of the Materials, as well as any materials, research, books, articles, and other works of authorship, as well as products or services, created by Atira Tan and related to the Training (collectively, “Materials”). Atira Tan retains all rights in and to all Intellectual Property utilized or referenced in the Training and the Materials including, but not limited to, the copyrights in the Materials and all associated trademarks. No Materials or any portion thereof are sold or otherwise transferred and Atira Tan does not sell any title, ownership right, or interest in or to any of the Materials. I will not acquire any right of ownership, in whole or in part, in and to any of the Intellectual Property. Any goodwill that accrues to the Intellectual Property because of my use of the Intellectual Property will inure to the sole benefit of Atira Tan and become the sole property of Atira Tan.

 I agree that all personal information of any participant relayed within the Training is strictly and completely confidential. I shall not disclose any of this confidential information to any other person or entity under any circumstances. I shall not make any audio, video, audiovisual, or other recordings of any portion of the Training nor shall I duplicate, reproduce, distribute, publish, or discuss any of the confidential information contained in or related to the Training. I agree not to record without prior permission.

Atira Tan shall not be liable or responsible for any unauthorized recording of the Training. I also agree that Atira Tan shall have no liability or responsibility for the use or exploitation of any unauthorized recordings.

 I understand that if at any time Atira Tan approves the recording of a Training, I hereby grant to Atira Tan the right and permission to film, photograph, videotape, and/or record me (including my image, picture, likeness, and/or voice) and to use the resulting film, photographs, videotapes, digital imagery and/or recordings (collectively, the “Footage”), as edited or altered by Atira Tan in order to create marketing and promotional materials, training materials and reports, or other work product created by or for the benefit of Atira Tan (“Work Product”). I hereby assign to Atira Tan all right, title, and interest to the Footage and Work Product, including, but not limited to, all copyrights, without any further compensation to me. I release and discharge Atira Tan from any and all claims and demands that may arise out of or in connection with the use of the Footage, including without limitation any and all claims for libel or violation of any right of publicity or privacy.

 If I agree to participate in the Training as the subject of a demonstration, I am doing so voluntarily and at my own risk. I understand that the demonstration session may include questions about my personal trauma history and emotional, psychological, and physical symptoms I may be experiencing. I further understand that I am under no obligation to participate in the demonstration, that I may refuse to answer any question, and that I may pause or discontinue my participation in the demonstration at any time at my discretion. Atira Tan has no liability or responsibility for my participation or involvement in any demonstration and I accept that any result or no result may occur due to my participation or involvement.

 I understand that the primary purpose for participating and receiving the Training is educational — to observe and experientially learn how Somatic Plant Medicine Integration principles are applied in practice so as to support my professional training and development.

 I will at all times indemnify and hold harmless the Institute, its officers, directors, agents, successors, and assigns, from and against any and all claims, actions, damages, costs, and expenses (including reasonable attorney fees) related to my acts or omissions in providing services related to any Training.

 I understand and agree that all my sessions, meetings, and consultations with Atira Tan’s assistants and staff (“Providers”) are undertaken at my own risk and that Atira Tan does not monitor, control, influence, or regulate Providers. I hereby release Atira Tan and its related parties from any and all liability or responsibility for any acts or omissions of any Provider and any claims related thereto. I understand that Atira Tan makes no representations or warranties about the characteristics or quality of the services I may receive.

 In the event that Atira Tan or its authorized representatives or agents or the Training coordinator or faculty member requests that I discontinue my participation and involvement with the Training, I will immediately leave the Training and the premises upon which the Training is being held. If I withdraw from the Training, the Atira Tan’s refund policy applies.

 I understand that my participation in or involvement with the Training (“Released Activities”) may present a health risk to me and/or, if I am pregnant or may be pregnant, to my unborn child. Illness, stress, and other periods of significant personal difficulty can present a health risk. If I may suffer from any health risk or be pregnant and elect to proceed with the Training I do so at my own risk. I accept full liability for my participation and involvement with the Training. If I withdraw from the Training due to any health risk or pregnancy, Atira Tan refund policy applies. I am voluntarily engaged in the Released Activities with the knowledge of the risks and assume any and all known and unknown risks of injury that may result from the Released Activities.

 I hereby release the Released Parties from all liability to me including my representatives, guardians, successors, assigns, heirs, children, and next of kin for all liability from or related to this Agreement or to the Released Activities. This release includes, without limitation, damage caused by the active or passive negligence of any of the Released Parties. I bear sole responsibility for all losses.

 This Agreement is the only agreement between me and Atira Tan regarding my participation in the Training, supersedes any other prior agreement, whether verbal or in writing, and cannot be modified except in writing by Atira Tan signed by the parties electronically or otherwise. This Agreement will be binding upon me and my heirs, executors, administrators, and legal representatives. I acknowledge that I have carefully read this Agreement, understand its contents, and understand that this Agreement includes an assumption of risk and release of the Released Parties’ negligence and a release of their liability. Participant acknowledges that Atira Tan is materially relying on this waiver in allowing me to engage in the Released Activities.

 I agree to abide by all Atira Tan’s policies, procedures, and guidelines as posted on www.atiratan.com. These policies, procedures, and guidelines are subject to change without notice to me and will be updated on the website. I understand and agree that it is my responsibility to check the website for updates and that I am nonetheless bound by all such policies, procedures, and guidelines.

This Agreement shall remain in full force and effect throughout my education and Training with Somatic Plant Medicine Integration Course.