RTS Essence Informed Consent Agreement

Essence, the Restoring the Soul Women’s Weekend, is an intense, immersive, personal growth and transformational experience. The time you spend at the Weekend is highly concentrated within a forty-two hour time frame between Friday November 10th and Sunday November 12th. Participants should be aware that participation may result in emotional and physical depletion. For this reason, we ask that you notify staff prior to the weekend with concerns or need for support.

1. I, (print full name below), hereby voluntarily consent to participate in the RTS Women’s Weekend. I understand this event is educational, experiential and focused on personal growth and transformation. I understand that the weekend is not designed or delivered in such a way as to be psychotherapeutic and is not a substitute for psychotherapy.
2. Activities: I understand that the workshop may consist of rigorous physical, mental, emotional, spiritual and intellectual activities which may take place within in large and small groups, solitude, contemplation, both in and out of doors as weather permits, and that these activities may be physically, emotionally and mentally demanding because the days are long, the content is intense and some participants may use profanity, express disturbing thoughts or emotions or experiences.
3. Risk: As with any activity, I acknowledge that there are always risks, including but not limited to physical injury, emotional stress, mental dissonance, or physical, emotional and mental fatigue. I understand that not all of the risks associated with the group activities occurring during the weekend are fully known or predictable because of the diverse backgrounds, temperaments and other individual characteristics of the participants.
4. Injury: I understand and acknowledge that I have carefully assessed my own physical, emotional and mental strength and endurance and have concluded that I am able to and wish to participate in the weekend. I understand and acknowledge that there are potential psychological, emotional and physical risks to me, those described above and those risks not specifically listed. I knowingly and voluntarily assume all of those risks and hereby release Restoring the Soul, its officers, directors, staff, employees, and agents from any and all liability for physical, emotional, psychological or other injuries to myself and for any injury to others caused by me.
5. Choice: I understand and acknowledge that my participation in the Weekend and in every separate part thereof is purely voluntary and that at all times I will be free to choose whether to participate in any part or all of the Weekend. I acknowledge my responsibility for exercising my own judgment and initiative in choosing what parts of the Weekend, if any, I will participate in.
6. Confidentiality: I understand that it is important for me to protect the privacy of other participants in the Weekend and therefore agree that I will not disclose the names or other means of identification of any other participants in the Weekend to any third party. I also agree that I will not directly or indirectly disclose any details of the Weekend processes, exercises, content, or materials to anybody.
7. Medical Awareness: I take responsibility for consulting with a medical doctor and/or psychotherapist prior to participating in the Weekend concerning any known or potential physical, mental or emotional condition that I have or may have, for the purpose of getting medical and/or psychotherapeutic recommendation and/or permission to participate.
8. Medical Intervention: I hereby authorize RTS and its officers, directors, employees, agents and staff to take any and all reasonable steps on my behalf in the case of any physical or other injury, illness or condition I might suffer during the Weekend. RTS, its officers, directors, employees, agents and staff may apply emergency first aid, engage physicians or any kind, nursing services, ambulance services, paramedic services, or any other service or personal that in the sole discretion and judgment of RTS, its officers, directors, employees, agents or staff may be deemed reasonable or necessary.

As a participant of the RTS Women’s Weekend, I have read, understood or asked for clarification about the information and policies presented in this form.  I consent to being a participant at the Women’s Weekend under these conditions.  I consent and freely choose to participate in the RTS Women’s Weekend under these conditions and with full knowledge of the above information.

I hereby agree to indemnify and hold harmless RTS, its officers, directors, employees, agents and staff of and from any and all liability, claims suits and damages, including but without limitation, the cost, arising out of or with respect to the engagement of such services and/or personnel on my behalf. Further, I hereby knowingly and voluntarily release RTS, its officers, directors, employees, agents, and staff of and from any liability for any physical or other injury that I may suffer as a result of participating in the RTS Women’s Weekend.