AkashicRequest

FREE ONLINE AKASHIC READINGSSM  – CONSENT AND RELEASE AGREEMENT

Conducted by Nithyanandeshwara Devasthanam Trust

Legal Name:*
Spiritual Name:
Address:*
Please Check (if applicable):
I am 18 years old or above*

*NOTE: FOR PARTICIPANTS UNDER THE AGE OF 18 (MINOR), MINOR’S  PARENT/LEGAL GUARDIAN MUST COMPLETE AND SIGN THIS FORM ON MINOR’S BEHALF.

Phone Number:*
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E-mail:*

Note: By providing your email address, you agree to receive emails from Nithyanandeshwar  Devasthanam Trust and its affiliates, which may  include, among other things, information on other programs/classes, promotions, newsletters, inspirational messages, and  tips about the Vedic/Hindu tradition.

In consideration of receiving services in connection with the Online Akashic ReadingsSM process (the Program) rendered by a Nithyananda GurukulSM Balasanth (hereinafter “Akashic Reader”) at no cost to me, I hereby declare as follows:

  • I have provided my true and legal name above.
  • I voluntarily chose to participate in the Program.
  • I am aware, that the Akashic Reader is under the age of 18 and is not licensed under the laws of any state to practice medicine or provide any other form of health care or the healing arts.
  • On my own behalf, and on behalf of my heirs, personal representatives and assigns, I HEREBY WAIVE, RELEASE, DISCHARGE, HOLD HARMLESS, AND PROMISE TO INDEMNIFY AND NOT TO SUE the Akashic Reader, Sri Nithyananda Swami, aka Paramahamsa Nithyananda, (“Swamiji”), Nithyanandeshwar Devasthanam Trust, Nithya Gnanadhan Trust, Dhyanapeeta Charitable Trust, Nithyananda University and their volunteers, any Program organizers, their affiliates, and/or anyone else directly or indirectly involved in sponsoring, hosting, administrating, marketing, teaching, organizing, managing, or conducting the Program (collectively “Releasees”) for any and all claims or demands arising out of any injury (including death), any form of mental distress, property loss, or other damages related to (i) my participation in the Program, whether those risks are known or unknown, and including BUT NOT LIMITED TO INJURIES, LOSSES OR DAMAGES CAUSED BY THE NEGLIGENCE OR ACTS OF THE RELEASEES TO THE MAXIMUM EXTENT PERMITTED BY LAW, or (ii) the condition of the premises in which the Program occurs, whether or not I am then participating in the Program.
  • I affirm that the Releasees has not made any representations, guarantees, warranties or promises to me with regard to the outcome of the Program, particularly with regard to the diagnosis, treatment or prevention of any disease, illness or physical or mental condition.
  • I understand that the Program is a religious, spiritual and meditation service only and is not a substitute for medical treatment, does not constitute medical diagnosis, care or treatment and does not constitute the practice of medicine or any other health care, healing arts or fate prediction profession.
  • I understand the Program is not intended to be any sort of guarantee or definitive statement about the past, present, or the future. I understand that in connection with the Program, the Released Parties do not make, and expressly disclaim and negate, any claims, representations, promises, express or implied warranties, or guarantees about me or that any particular result can be obtained for me, including but not limited to any mental, physical, emotional, spiritual, financial, or other results.
  • I understand that if I have any physical or mental complaints, I should consult a licensed medical professional or other health care provider separately.
  • I agree not to video or audio record any reading I receive from Reader or of anyone else receiving a reading.
  • By signing this form, I hereby grant to Nithyanandeshwar Devasthanam Trust and anyone it designates the right to record me at any Nithyanandeshwar Devasthanam Trust event, by any means and in any format and media (“Recordings”). (Recordings also include any testimonials I submit to Nithyanandeshwar Devasthanam Trust.) Nithyanandeshwar Devasthanam Trust will own the Recordings, and I agree that it may utilize them however it wants to, in whole or in part, anywhere in the world, and in any format and media.
  • I expressly agree that this waiver and release is intended to be as broad and inclusive as permitted by the laws of India, and that if any portion hereof is held invalid, the remainder shall continue in full force and effect.

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Signature (Type First and Last Name):*

*NOTE: IF UNDER THE AGE OF 18, LEGAL GUARDIAN MUST SIGN. 

Verification: