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EMDR
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Advanced Certificate in Dissociation Studies
for EMDR Therapists
Expressive Arts
Certificate of Expressive Arts Therapy
Supervision in Expressive Arts Therapy
Expressive Arts Therapy Graduates
Calendar
Resources
About
About Dr. Jamie Marich
Our Team
Continuing Education Approvals
Diversity & Social Justice Scholarship
Organizational Policies
Contact
Home
EMDR
EMDR Therapy Training
EMDR Advanced Topics Courses
EMDR Consultation
EMDR Faculty Network
Advanced Certificate in Dissociation Studies for EMDR Therapists
Expressive Arts
Certificate of Expressive Arts Therapy
Supervision in Expressive Arts Therapy
Expressive Arts Therapy Graduates
Calendar
Resources
About
About Dr. Jamie Marich
Our Team
CE Approvals
Diversity & Social Justice Scholarship
Organizational Policies
Directory
Publishing
ICM Blog: Redefine Therapy
Contact
Home
EMDR
EMDR Therapy Training
EMDR Advanced Topics Courses
EMDR Consultation
EMDR Faculty Network
Advanced Certificate in Dissociation Studies for EMDR Therapists
Expressive Arts
Certificate of Expressive Arts Therapy
Supervision in Expressive Arts Therapy
Expressive Arts Therapy Graduates
Calendar
Resources
About
About Dr. Jamie Marich
Our Team
CE Approvals
Diversity & Social Justice Scholarship
Organizational Policies
Directory
Publishing
ICM Blog: Redefine Therapy
Contact
Participant Release and Waiver Form
This Release and Waiver (“Release”) executed on 08/31/2025 by the Participant releases Institute for Creative Mindfulness, Inc., its subsidiaries and affiliates, directors, officers, faculty, consultants, employees, and agents, and their respective successors and assigns (“ICM”) from all liability relating to the activities described below. The Participant desires to participate in a voluntary movement-based course such as yoga, dance, self-defense, or other expressive movement offered by ICM’s faculty, consultants, or affiliates (“Course”).
In consideration for my participation in the Course, I, the Participant, agree as follows:
1. Waiver and Release:
*
I release and forever discharge and hold harmless ICM from any and all liability, claims, and demands of any nature, either in law or in equity, which arise or may hereafter arise from my participation in the Course. I understand and acknowledge that this Release discharges ICM from any liability or claim that I may have with respect to bodily injury, personal injury, illness, death, mental distress or property damage that may result from my participation in the Course.
I agree.
2. Insurance
*
I understand that ICM assumes no obligation to provide me with financial or other assistance, including but not limited to workers’ compensation, medical, health, or disability benefits or insurance. I expressly waive any such claim for compensation or liability on the part of ICM in the event of injury or medical expenses incurred by me. I am responsible for my own insurance coverage in the event of personal injury or illness as a result of participation in the Course.
I agree.
3. Indemnification
*
I agree to indemnify and hold harmless ICM from any and all claims brought by or on behalf of me, my spouse or dependent children resulting from my participation in the Course.
I agree.
4. Medical Treatment:
*
I hereby release and forever discharge ICM from any claim whatsoever that arises or may hereafter arise on account of any first-aid treatment or other medical services rendered in connection with my participation in the Course.
I agree.
5. Fitness for Course:
*
I represent that I am physically fit to perform all activities that may be associated with or required by the Course and agree that I am solely responsible for all health risks associated with such activities. If I have concerns, I have addressed them with my treating physician. Any modifications made in the course to address physical limitations are not a substitute for professional medical advice.
I agree.
6. Technical Requirements:
*
If I am attending an online version of Course, I understand that they will be hosted by the Zoom platform and I have the technical capabilities to connect via Zoom. I understand that I should work out any technical difficulties in advance of the Course and acknowledge I have the appropriate technological requirements to participate.
I agree.
7. Miscellaneous:
*
I expressly agree that this Release is intended to be as broad and inclusive as permitted by the laws of the State of Ohio and that this Release shall be governed by and interpreted in accordance with the laws of the State of Ohio and any disputes be brought in and subject to the jurisdiction of the courts of the State of Ohio, County of Trumbull. I agree that in the event that any clause or provision of this Release is deemed invalid, the enforceability of the remaining provisions of this Release shall not be affected.
I agree.
Legal Name ("Participant")
*
First Name
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Participant Signature
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By signing below, I express my understanding and intent to enter into this Release willingly and voluntarily.
Date
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