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Phone Number (required)

I acknowledge the contagious nature of the Coronavirus/COVID-19 and many other public health authorities still recommend practicing social distancing.

I further acknowledge that Sarah Dakhili has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

I further acknowledge that Sarah Dakhili cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, other workshop attendees and their
families.

I voluntarily seek services provided by Sarah Dakhili and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my session with Sarah.

I attest that:

· I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.
· I have not travelled internationally within the last 14 days.
· I have not travelled to a highly impacted area within Australia in the last 14 days.
· I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.
· I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.
· I am following the recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

I hereby release and agree to hold Sarah Dakhili harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure that may otherwise arise in any way in connection with any services received from Sarah Dakhili.

I understand that this release discharges Sarah Dakhili from any liability or claim that I, my heirs, or any personal representatives may have against the workshop/session with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Sarah Dakhili. This liability waiver and release extends to the workshop/session run by Sarah Dakhili, together with all owners, partners, and employees.

I have read and accept everything mentioned above. (required)