By checking the box, it counts as an electronic signature, and by signing this agreement (“Agreement”), I acknowledge that, with respect to services rendered by Elizabeth Duncanson, Body Temple Online, a dba of Elizabeth Duncanson, a California sole proprietorship, and their employees and agents (collectively “Company”), you understand the following:
General Description of Services
Company provides movement education for everyone, provides approved evidence based continuing education for Yoga professionals, and provides live and recorded online workshops. The information provided is for educational purposes only and is not physical therapy treatment or advice. The education and information provided integrates the disciplines and some foundations of holistic physical therapy (although no physical therapy advice is given nor is a physical therapist-patient relationship established), sports medicine, pelvic health, fitness, and yoga. Company’s available services include workshops, webinars, presentations, and online events (“Services”). Some available Services include tips for how to avoid musculoskeletal pain while working, exercising, living and sheltering at home, the ability to connect with a community of real people on the same healing path, and the ability to have live meet-ups with Liz Duncanson. The purpose of the Services are to help clients and practitioners heal and learn.
General Office Policies
Group Meet-Ups. When scheduling to participate in a group meet-up with Company, please provide your name, phone number, and any updated contact information. Please be on time. Please have payment available for every group meet-up.
Cancellation: Company requires prepayment in advance prior to any scheduled webinar, workshop, presentation, or online event (collectively referred to as “Online Event”). If you miss your Online Event, you forfeit the value of the Online Event. You agree that you will not receive a refund or reimbursement for the value of the Online Event in case you miss the Online Event or cancel your participation in the Online Event.
No Refunds. Company does not offer any refund for visits or Services of any kind.
No Guarantees. Company does not guarantee any specific result. It is the client’s responsibility to follow through on seeking medical care and treatment by a licensed medical provider.
Not a Healthcare Provider: Company is not a medical or healthcare provider and will not provide medical advice, treatment, or physical therapy advice. You should seek medical treatment, care, and follow-up with a licensed medical or healthcare provider.
Online and phone communication; Electronic signatures. Company stores office records digitally. While Company makes reasonable efforts to keep the data secure according to legal requirements, and maintains the privacy and confidentiality of client data, you understand that no system is 100% secure. You agree that electronic signatures below are the legal equivalent of manual signatures on this Agreement, and manifest consent to be legally bound by this Agreement’s terms and conditions.
Office Insurance Practices and Client Financial Responsibility
Payment: Company accepts various credit cards. Company bills to your debit or credit card on file unless you provide alternate payment information and instructions.
Fees: Company’s fee schedule is:
□ Yoga Continuing Education (3.5 hours): $195 (price subject to change).
No Participation in Insurance Plans or Medicare: Company does not participate in any insurance panels or Medicare, and does not accept assignment from any insurance company. Consequently, you are responsible for payment in full at time of service and charges are determined by Company.
Your Financial Responsibility: You are financially responsible for any charges for services. You also agree to be responsible for costs and expenses, including court costs, attorney fees and interest, should it be necessary for Company to take action to secure payment of an outstanding balance.
Additional Modalities are Not Included: Company may educate you on such modalities, including but not limited to, recommended lifestyle choices, products, yoga, personal training, physical therapy, etc. It is your responsibility to pay for these additional modalities and are they are not included with Company’s fees.
Fair Market Value. Company believes that the Fee(s) represent(s) fair market value of the services contemplated hereunder; is/are not determined in a manner that take(s) into account the volume or value of any referrals or business otherwise generated between the parties for which payment may be made, in whole or in part, under Medicare or any state health care program, as defined under Section 1128B of the Social Security Act; and does not involve the counseling or promotion of a business arrangement or other activity that violates any state or federal law. Nothing contained in this Agreement, including any compensation paid or payable, is intended or shall be construed: (i) to require, influence, or otherwise induce or solicit either party regarding referrals of business, or recommending the ordering of any items or services, of any kind whatsoever to the other party or any of its affiliates, or to any other person, or otherwise generate business between the parties; or (ii) to interfere with a patient’s right to choose his or her own health care provider, or with a physician’s medical judgment regarding the ordering of any items or services.
Disclaimer of Warranties; Limitation of Liability. Company disclaims all warranties, both express and implied, including any warranty of non-infringement, fitness for a particular purpose or merchantability; and Company’s liability hereunder shall be limited to the aggregate fees paid to Company by you for the services until termination. Company has no liability to you for any incidental and consequential damages, whether or not foreseeable or contemplated by Company (including but not limited to any loss, cost, injury, or expense caused by, or resulting from, a delay in responding to you, whether from technical failures or otherwise).
Disclaimer of Guarantee. You accept and agree that you are 100% responsible for progress and results based on services you received from Company. Company makes no representations or guarantees verbally or in writing regarding performance of this Agreement other than those specifically enumerated herein. Although Company aims to enhance overall education in wellness which can lead to good outcomes, Company makes no guarantee or warranty that the services will meet your requirements or that you will achieve the same results, or any particular result.
Indemnification. You agree you will defend, indemnify, and hold harmless Company, Company’s shareholders, trustees, affiliates, and successors from and against any and all liabilities and expense whatsoever—including without limitation, claims, damages, judgments, awards, settlements, investigations, costs, attorney’s fees, and disbursements—which any of them may incur or become obligated to pay arising out of or resulting from the offering for sale, the sale, and/or use of services or products or services under this Agreement; excluding, however, any such expenses and liabilities which may result from a breach of this Agreement or sole negligence or willful misconduct by Company, or any of its shareholders, trustees, affiliates or successors.
Intellectual Property. Company’s copyrighted and original materials will be provided to you for individual use only and a single-user license. You are not authorized to sell any of Company’s intellectual property for your own business purposes. You are not authorized to share, copy, distribute, or otherwise disseminate any materials received from Company electronically or otherwise without the prior written consent of Company. All intellectual property, including Company’s copyrighted materials, shall remain the sole property of Company. No license to sell or distribute Company’s materials is granted or implied.
Clear understanding. You acknowledge that the terms of this Agreement are clear and that no undue pressure has been exerted on you to sign this Agreement.
Notices and Communications. Any communication required or permitted to be sent under this Agreement shall be in writing and sent via U.S. mail or email to the addresses set forth in this Agreement. Any change in address shall be communicated in accordance with this section; and you are solely responsible for updating Company with respect to any change of address (including email address).
If you wish to send email communications to and receive email responses from Company, you acknowledge that email is not a secure medium for sending and receiving sensitive information, including protected health information. You also acknowledge and understand that an email or secure message in any form is not a good medium for urgent or time-sensitive communications.
Video Conferencing. Company has made significant efforts to keep the video conferencing feed secure, and Company only provides access to valid registrants for Online Events. But even with these attempts, security is not guaranteed, and it is important that you do not share any personal information or protected health information during these Online Events. Doing so is entirely at your own risk, and presenters are not liable for the misuse of any information you voluntarily share during these Online Events. You further acknowledge and understand that your statements and questions during these Online Events will be audible and/or visible to other attendees or participants and possibly to those watching any recorded segments of the Online Events. These Online Events may or may not be recorded and those recordings are the sole property of Company and the Online Event recordings and all content associated with the Online Events can be used in any way and for any purpose without consent of you, the attendees, or participants.
Severability. In the event that any provision of this Agreement, or the application thereof, becomes or is declared by a court of competent jurisdiction to be illegal, void or unenforceable, the remainder of this Agreement shall continue in full force and effect and the application of such provision to other persons or circumstances shall be interpreted so as reasonably to effect the intent of the Parties. This Section shall survive termination or expiration of this Agreement.
Entire Agreement; Amendment. The undersigned agrees to the terms of this Agreement, all of which are expressed herein. There are no promises or representations except as set forth in the Agreement. No amendment of this Agreement shall be binding on a party unless made in writing and signed by all parties. Notwithstanding the foregoing, Company may unilaterally amend this Agreement to the extent required by law or regulation by sending you advance written notice of any such change; any such changes are incorporated into this Agreement by reference without the need for signature by the parties and are effective as of the date established by Company.
No assignment: This Agreement is not transferrable or assignable without Company’s prior written consent.
Governing Law. This Agreement shall be governed by and construed in accordance with laws of the State of California without regard to California’s choice of law provisions.
Arbitration. In the event that any dispute arises between the parties arising out of or related to the validity, interpretation, enforcement, or performance of this Agreement, or otherwise arising out of the relationship between the parties or the termination of that relationship, and a party wishes to pursue the dispute, such party shall submit the dispute to binding arbitration in accordance with the Commercial Rules of the American Arbitration Association (“AAA”). The Arbitration shall be held in Walnut Creek, CA. The arbitrator(s) shall apply California substantive law, or federal substantive law where state law is preempted. The arbitrator(s) shall have the power to grant all legal and equitable remedies provided by the above state law and award compensatory damages provided by the above state law, except that punitive damages shall not be awarded. The arbitrator(s) shall prepare in writing and provide to the parties an award including factual findings and the legal reasons on which the award is based. The arbitrator(s) shall not have the power to commit errors of law or legal reasoning. Any judicial review of the arbitrator(s) decision shall be governed by the above state law. EACH PARTY HAS READ AND UNDERSTANDS THIS SECTION, WHICH DISCUSSES MEDIATION AND ARBITRATION. EACH PARTY UNDERSTANDS THAT BY SIGNING THIS AGREEMENT, THE PARTY AGREES TO SUBMIT ANY CLAIMS ARISING OUT OF, RELATING TO, OR IN CONNECTION WITH THIS AGREEMENT, OR THE INTERPRETATION, VALIDITY, CONSTRUCTION, PERFORMANCE, BREACH, OR TERMINATION THEREOF TO ARBITRATION, AND THAT THE DISPUTE RESOLUTION PROVISIONS SET FORTH IN THIS SECTION CONSTITUTE A WAIVER OF THE PARTY’S RIGHT TO A JURY TRIAL.
Please keep a copy of this Agreement for your reference. You may submit this Agreement and the other forms by mail, e-mail, fax or in-person.
I have carefully read this form, which is printed in English, and acknowledge that English is a language I read and understand, and that I understand the form. I do not feel rushed or impaired, nor am I under the influence of a sedative or sleep-inducing medication.
I accept and agree to all of the terms above. I am free to refuse or withdraw my consent and to discontinue participation in any treatment, service, or research at any time without fear of reprisal against or prejudice to me. No representations, statements, or inducements, oral or written, apart from the foregoing written statement, have been made. I may request and receive a copy of this form from Company. If any portion of this form is held invalid, the rest of the document will continue in full force and effect.