Indemnity Form

INDEMNITY FORM
All visitors to the Casa de Dom Inacio are required to sign this Indemnity before presenting themselves for treatment.

CONSENT
A visit to the Casa de Dom Inacio, (herein after referred to as the "Center") constitutes consent to all provisions made herein. The participant acknowledges that at no time did the Center or any of its employees, paid or voluntary, or Tony Garza and his staff promise or imply a definite cure of the participant's medical condition. Any treatment is undertaken at the free will of the undersigned without pressure by the Center, Tony Garza or their agents.

INDEMNITY
The undersigned agrees to Indemnify the Center, its staff and the Medium Joao Teixeira da Faria, as well as Tony Garza and his staff from any legal proceedings arising from treatment at the Center and agrees that in presenting themselves for treatment they agree to accept that treatment without complaint or recourse. The Center and Tony Garza are not responsible for any physical, mental, emotional or other reaction, trauma, ailment or demise during the visit or occurring afterwards that the participants may experience at the power vortexes or sites or from any lecture, treatment or session of any kind, including private sessions at the Casa de Dom Inacio. It is acknowledged that, while every due care is exercised by the Center, its staff and volunteers and Tony Garza and his staff, to ensure the comfort and well being of the undersigned and their companions, the responsibility for any loss (including personal injury, death, and/or property loss) accident, misfortune, or deterioration of existing medical conditions shall always be the responsibility of the undersigned.

INSURANCE
It is the personal responsibility of the participant to carry any necessary insurance for the full duration of their visit in respect to illness, injury, death, and loss of belongings or airline flights.

INOCULATIONS
The decision to vaccinate or inoculate is the sole responsibility of the participant. The Center is not responsible for any health conditions or ailments contracted during or as a result of, the visit to the Center. I accept the conditions of Indemnity as listed above.

__________________________________________________
Signature

__________________________________________________
Print Name

__________________________________________________
Address

__________________________________________________
City, State, Zip

Date: ________ /________ /200


				John of God Indemnity Form



	Escorted Journeys \| John of God \| Treatments \| Casa de Dom Inacio \| Testimonials \| Dates/Costs/Services \| Additional Services \| Journey Application \| Contact Tony


		INDEMNITY FORM All visitors to the Casa de Dom Inacio are required to sign this Indemnity before presenting themselves for treatment. CONSENT A visit to the Casa de Dom Inacio, (herein after referred to as the "Center") constitutes consent to all provisions made herein. The participant acknowledges that at no time did the Center or any of its employees, paid or voluntary, or Tony Garza and his staff promise or imply a definite cure of the participant's medical condition. Any treatment is undertaken at the free will of the undersigned without pressure by the Center, Tony Garza or their agents. INDEMNITY The undersigned agrees to Indemnify the Center, its staff and the Medium Joao Teixeira da Faria, as well as Tony Garza and his staff from any legal proceedings arising from treatment at the Center and agrees that in presenting themselves for treatment they agree to accept that treatment without complaint or recourse. The Center and Tony Garza are not responsible for any physical, mental, emotional or other reaction, trauma, ailment or demise during the visit or occurring afterwards that the participants may experience at the power vortexes or sites or from any lecture, treatment or session of any kind, including private sessions at the Casa de Dom Inacio. It is acknowledged that, while every due care is exercised by the Center, its staff and volunteers and Tony Garza and his staff, to ensure the comfort and well being of the undersigned and their companions, the responsibility for any loss (including personal injury, death, and/or property loss) accident, misfortune, or deterioration of existing medical conditions shall always be the responsibility of the undersigned. INSURANCE It is the personal responsibility of the participant to carry any necessary insurance for the full duration of their visit in respect to illness, injury, death, and loss of belongings or airline flights. INOCULATIONS The decision to vaccinate or inoculate is the sole responsibility of the participant. The Center is not responsible for any health conditions or ailments contracted during or as a result of, the visit to the Center. I accept the conditions of Indemnity as listed above. __________________________________________________ Signature __________________________________________________ Print Name __________________________________________________ Address __________________________________________________ City, State, Zip Date: ________ /________ /200







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