Please complete the items below. First Name * Last Name * Email * Phone (###) ### #### Is there any thing you wish to share with me before our time together? TERMS OF SERVICE * I have read and agree to the Terms of Service. See here -- https://www.theawokenchild.com/terms-of-service for the Terms of Service. By clicking YES below you agree to our Terms of Service. YES I understand that I will be participating in a energy healing session. The session may consist of touch, words, guidance, manipulation of energy, etc. This is not a medical treatment nor is the information provided during the session intended to treat, diagnose, cure, or prescribe. I agree to hold my practitioner(s) harmless for any reactions resulting from this session (or series of sessions). I understand that Energetic Practitioners are NOT licensed for massage or medical treatment. I understand that it is always recommended to check with my physician before this or any healing work. Understanding the above, I give my permission for this healing work. * ELECTRONIC SIGNATURE* - Type First and Last Name Date MM DD YYYY Thank you. I am looking forward to sharing some sweetness with you soon. Thank you. I am looking forward to our time together. —Mary
