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RELEASE AND CONFIDENTIALITY AGREEMENT DIVINE JOURNEYS HEALING ARTS CENTER
I, _________________________________, enter into this Agreement with Karen Anderson of Divine Journeys Healing Arts Center to confirm in this Agreement the conditions of my participation in the reading to be performed by Karen Anderson. I have been made aware that the 90 minute session is Pre-Paid and the cost is $180.00 for one person (21-up) and $40.00 for each additional person. (Group sessions are 4 or less and share the 90 minutes in the session.) I have also been made aware that there is a $40.00 held back cancellation fee, if I cancel my appointment and do not reschedule within a two week period.
I,
______________________________
I have carefully
read this Agreement
and fully understand
it's contents, terms
and significance and
understand the legal
consequences of
signing this
Agreement. I am
aware that this
Agreement contains a
release of liability
and a contract
between myself and
Karen Anderson of
Divine Journeys
Healing Arts Center
and I sign this
Agreement of my own
free will. I also
have been made aware
that Karen
Anderson of Divine
Journeys Healing
Arts Center will
be tape recording
this session for my
own future referral
to and are in
agreeance with this
procedure. Please print, sign, and fax to 866-486-0415 or mail to Karen Anderson, PO Box 1112, Somis, CA 93066
Dated: ______________________ Signed: ____________________________________________ Email: _____________________________________________ Address:_________________________________________________________________________________
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