TERMS AND CONDITIONS
PLEASE READ CAREFULLY.
Valerie-Anne Cyr, operating as BrainNew Therapy Inc. offers hypnosis, Rapid Transformational Therapy (RTT), laser training, meditation and other energy therapy techniques and services (the "Services"). The Services provided by Valerie-Ann Cyr, her volunteers, employees, agents and representatives (collectively "BrainNew Therapy Inc.") are intended to assist with your overall physical and mental wellbeing.
The Services provided by BrainNew Therapy Inc. are not intended to serve as medical advice, diagnosis and/or treatment, and the information and Services provided should not be construed as a substitute for medical advice, opinion, consultation, evaluation and/or treatment.
REGISTRANT SHOULD UNDERSTAND AND RECOGNIZES THE FOLLOWING:
I understand that Valerie-Anne Cyr is a licensed physician and practitioner; however, I also understand that BrainNew Therapy Inc. is not a medical organization and the Services provided by Valerie-Anne Cyr and BrainNew Therapy Inc. will not, in any way, be a medical consultation, medical diagnosis, prevent, cure or treat any medical or mental condition and that neither Valerie-Anne Cyr nor BrainNew Therapy Inc. will prescribe any medication.
If I am currently under the care of a mental health professional, I must consult with my healthcare provider(s) prior to beginning Services. In addition, I understand and acknowledge that I must consult with my doctor(s) as soon as I notice any changes in my health and/or well-being, and before making any changes to my medical regimen.
BrainNew Therapy Inc. cannot guarantee any particular outcome or degree of success. I also acknowledge that there may be significant risks associated with my health condition and/or illness, and I assume full responsibility for my physical, mental or emotional well-being, decisions, actions and inactions, including any exacerbation and/or worsening of my physical, mental or emotional well-being.
My participation in the Services provided by BrainNew Therapy Inc. is completely voluntary. I also understand and acknowledge that BrainNew Therapy Inc. also has the right to discontinue providing the Services at any time.
By completing this form, I give my full permission to BrainNew Therapy Inc. to hypnotize me, to use Rapid Transformational Therapy and to provide the Services described and agreed upon, now and in the future.
I give my full permission to BrainNew Therapy Inc. to respectfully lift my arm, touch my shoulder or cradle my head during my Rapid Transformational Therapy sessions in order to facilitate the deepening process.
I give my full permission to BrainNew Therapy Inc. to make audio recordings that may include my voice (the "Recordings"). I understand that if Recordings are made during or after my session(s), BrainNew Therapy Inc. retains full copyright to all forms of media that may be produced and distributed to me.
In order to provide appropriate Services, BrainNew Therapy Inc. may collect information about you ("Personal Information"). BrainNew Therapy Inc. is committed to protecting your Personal Information - 2- and will only request it to the extent necessary for the services provided. Every reasonable effort will be made to protect and safeguard your Personal Information; however, technology and infrastructure may be subject to compromise due to human error, malfeasance or other disruptions.
I consent to the storage of my Personal Information and records, which I acknowledge are provided by me, voluntarily.
I understand and acknowledge that electronic communications present greater risks to privacy and confidentiality and that by participating in these types of communications, I accept full responsibility for the increased risk of disclosure of my Personal Information and Records, including any responses to my electronic communications by BrainNew Therapy Inc.
I understand and acknowledge that the law may require BrainNew Therapy Inc. to disclose information discovered about me, including but not limited to: (a) abuse, and (b) situations of serious physical threat or imminent danger.
IN CONSIDERATION OF MY PARTICIPATION IN THE SERVICES PROVIDED BY BrainNew Therapy Inc, on behalf of myself and my heirs, assigns and personal representatives, I AGREE THAT:
- BrainNew Therapy Inc. means Valerie-Anne Cyr operating as BrainNew Therapy Inc. and its employees, representatives, agents, volunteers and assignees and CLAIMS means any claim, cause of action or liability of any kind;
- I VOLUNTARILY ASSUME AND AGREE, WITHOUT LIMITATION, TO BE RESPONSIBLE FOR ALL RISKS ASSOCIATED WITH MY ATTENDANCE OR PARTICIPATION IN THE SERVICES PROVIDED;
- I ASSUME FULL RESPONSIBILITY for understanding and following safe practices associated with my safety, health and/or personal condition, including regular consultation with my physician(s);
- I RENOUNCE AND RELEASE ALL CLAIMS that I may have now or in the future, against BrainNew Therapy Inc. arising out of or resulting directly or indirectly from my presence or participation in the Services provided by BrainNew Therapy Inc;
- I RENOUNCE BrainNew Therapy Inc. from any and all liability for any loss, damage, injury or expenseof any kind or nature that may occur, in whole or in part, as a result of my participation in the Services, regardless of whether I have followed and/or properly applied the Services provided;
- I DISCLAIM ANY CLAIMS I may have now or in the future arising out of or attributable to any breach of my Personal Information, however caused, including, but not limited to, negligence or breach of any duty of care;
- I WILL INDEMNIFY, DEFEND AND HOLD HARMLESS Valerie-Anne Cyr and BrainNew Therapy Inc. from any and all claims or actions brought by third parties for loss, damage, injury or expense suffered or incurred by me or any other person in connection with my presence or participation in the Services;
- IN NO EVENT shall BrainNew Therapy Inc. be liable to me for any damages in excess of the amounts I paid for the Services provided.
