Reiki Student Waiver

Please fill out the following form before attending the first class. Thank you!

Name to be on certificate

Date of Birth

Address

Phone

Emergency Contact

Phone

How did you hear about Sol?

Have you received reiki before?

Yes

Do you have any intentions for taking this course that you want to share? Any comments, concerns, or questions to be addressed at class?

I have read the release and by signing this form below, I agree that I fully understand the contents of this release formView Energy Consent + Release Form

Please accept if you have acknowledged that I may occasionally be taking screenshots, photos, or recordings throughout class for marketing purposes, replay’s, and may share with future cohorts. Personal information, including personal stories shared during the class, will not be used for marketing purposes without obtaining written permission beforehand. Your privacy and comfort is a priority. If you have any concerns or would like to discuss this further, please feel free to reach out to me.

I declare that the info I’ve provided is accurate & complete

Print your name

Date Signed

Your Signature

Thanks for submitting!