HealthRHYTHMS Waiver

Participant Waiver and Release of Liability
Health Rhythms Drumming Program
Hosted by Eileen Woods and Intersections

Participant Name: ____________________________________
Date of Birth (if under 18): ____________________________
Event Date: __________________________________________

Emergency Contact Name: _____________________________
Phone Number: _______________________________________

Please read carefully before signing.

I acknowledge that my participation in the Health Rhythms Drumming Program involves physical activity and group interaction, which may include repetitive hand movements, standing, and/or exposure to sound levels consistent with drumming. I understand that any activity carries the potential for physical injury or emotional discomfort, and I voluntarily assume all risks associated with my participation.

I hereby waive, release, and discharge Eileen Woods and Intersections from any and all claims, liabilities, demands, actions, or causes of action arising out of or in connection with any injury, illness, or loss I may sustain while participating in this event, including travel to and from the program site.

I certify that I am physically and mentally capable of participating in the event and that I will inform the facilitator of any relevant medical conditions or concerns before the session begins. I agree to participate responsibly and to follow all instructions given by the event facilitator.

Signature of Participant: _________________________________
Date: _______________