IN CONSIDERATION OF the risk of injury that exists while participating in Practitioner Level 2 Training
(hereinafter the "activity"); and
IN CONSIDERATION OF my desire to participate in said activity and being given the right to
participate in same;

I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives
(hereinafter collectively, "releasor," "I" or "me", which terms shall also include releasor's
parents or guardian if the releasor is under 18 years of age), knowingly and voluntarily enter into
this waiver and release of liability and hereby waive any and all rights, claims or causes of
action of any kind arising out of my participation in the activity; and

I HEREBY release and forever discharge Brenda Winkle Empowerment located at your
13110 SW Aubergine Terrace, Sherwood, Oregon 97140; their affiliates, managers, members, agents, attorneys, staff,
volunteers, heirs, representatives, predecessors, successors and assigns (collectively "releasees"),
from any physical or psychological injury that I may suffer as a direct result of my participation
in the aforementioned activity.

I am voluntarily participating in the aforementioned activity and I am participating in
the activity entirely at my own risk. I am aware of the risks associated with participating
in this activity, which may include, but are not limited to: physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including
paralysis), economic or emotional loss, and death. I understand that these injuries or
outcomes may arise from my own or others' negligence, conditions related to travel to
and from the activity, or from conditions at the activity location(s).

Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in this activity.

I FURTHER AGREE to indemnify, defend and hold harmless the releasees against any and
all claims, suits or actions of any kind whatsoever for liability, damages, compensation or
otherwise brought by me or anyone on my behalf, including attorney's fees and any related
costs.

I FURTHER ACKNOWLEDGE that releasees are not responsible for errors, omissions, acts or
failures to act of any party or entity conducting a specific event or activity on behalf of releasees.
In the event that I should require medical care or treatment, I authorize Brenda Winkle Empowerment, LLC to provide all emergency medical care deemed necessary, including but
not limited to, first aid, CPR, the use of AEDS, emergency medical transport, and sharing of
medical information with medical personnel. I further agree to assume all costs involved
and agree to be financially responsible for any costs incurred as a result of such treatment.
I am aware and understand that I should carry my own health insurance.

I FURTHER ACKNOWLEDGE that this activity may involve a test of a person's physical and
mental limits and may carry with it the potential for death, serious injury, and property loss.
I agree not to participate in the activity unless I am medically able and properly trained, and
I agree to abide by the decision of Brenda Winkle Empowerment, LLC's official or agent,
regarding my approval to participate in the activity.
I hereby acknowledge that I have carefully read this "waiver and release" and fully
understand that it is a release of liability. I expressly agree to release and discharge Brenda Winkle Empowerment, LLC and all of its affiliates, managers, members, agents, attorneys,
staff, volunteers, heirs, representatives, predecessors, successors and assigns, from any
and all claims or causes of action and I agree to voluntarily give up or waive any right that
I otherwise have to bring a legal action against Brenda Winkle Empowerment for personal
injury or property damage.
To the extent that statute or case law does not prohibit releases for ordinary negligence, this
release is also for such negligence on the part of Brenda Winkle Empowerment, LLC, its agents,
and employees.
I agree that this release shall be governed for all purposes by law, without regard to any
conflict of law principles. This release supersedes any and all previous oral or written
promises or other agreements.
In the event that any damage to equipment or facilities occurs as a result of my or my
family's or my agent's willful actions, neglect or recklessness, I acknowledge and agree to be
held liable for any and all costs associated with any such actions of neglect or recklessness.
THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF
MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF
PARTICIPATION.
THIS AGREEMENT was entered into at arm's-length, without duress or coercion, and is to be
interpreted as an agreement between two parties of equal bargaining strength. Both
participant, ________________________________ and Brenda Winkle Empowerment, LLC agree that

this agreement is clear and unambiguous as to its terms, and that no other evidence shall
be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted
based on the language in accordance with the purposes for which it is entered into.
In the event that any provision contained within this release of liability shall be deemed to
be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be
determined to be unlawful or otherwise unenforceable, the remainder of this agreement
shall remain in full force and effect. If a court should find that any provision of this
agreement to be invalid or unenforceable, but that by limiting said provision it would
become valid and enforceable, then said provision shall be deemed to be written, construed
and enforced as so limited.
In the event of an emergency, please contact the following person(s) in the order presented:

EMERGENCY CONTACT CONTACT RELATIONSHIP CONTACT TELEPHONE

I, the undersigned participant, affirm that I am of the age of 18 years or older, and that
I am freely signing this agreement. I certify that I have read this agreement, that I fully
understand its content and that this release cannot be modified orally. I am aware that
this is a release of liability and a contract and that I am signing it of my own free will.

SIGNATURE
PARTICIPANT'S ADDRESS
PARTICIPANT'S NAME

DATE:

(You'll be provided with a digital copy upon completion of purchase)