EVENT RELEASE FORM AGREEMENT:

By paying for this event, I acknowledge that I am willingly agreeing to attend a backyard sound healing / sound mediation at 110 Adams St. Hoboken, NJ, facilitated by
Roger Ansanelli, at the home of Pete and Heidi Conlin.
I understand that I am fully responsible for my own equipment such as, but not limited to: mat, blanket, water. Nothing will be provided. There is no private parking available and there is no bathroom facility (except for in an emergency). There is no handicap accessibility available at this private home. And that no one will be permitted to take my place.

I agree to wear a mask to the event, during the event, and from the event - without exceptions. This protocol is in place to protect you and all present. No pets are allowed.

I understand that my pre-paid attendance fee of $25 is non refundable due to the limited availability at the event.

Any cancellation for weather will be announced by 5pm day of event and posted on my site. Monies paid, in the cancellation for weather, will be applied as a credit toward a future sound mediation.

By voluntarily signing up for this event, I attest that I am not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever, chills, muscle pain, headache, sore throat, or new loss of taste or smell.

I have not traveled internationally within the last 14 days nor have I traveled to a highly impacted area within the United States of America in the last 14 days.

I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.

I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.

I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

Roger Ansanelli nor Pete and Heidi Conlin can not guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to other participants and their families.

I voluntarily acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while at the meditation.

I attest that: I hereby release and agree to hold Roger Ansanelli and Pete and Heidi Conlin harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act, or that may otherwise arise in any way in connection with any participation in said sound mediations.

I understand that this release discharges Roger Ansanelli and Pete and Heidi Conlin from any liability or claim that I, my heirs, or any personal representatives may have against the named persons with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any participation in the sound healing/ sound mediations.



PAYMENT INSTRUCTIONS:

Please read and follow the steps provided to make your payment process easy.

PAYING THROUGH ZELLE:

Account: rogeransanelli@yahoo.com

Your place is reserved once your payment is received.

All payments are final and non-refundable, and no one will be admitted unless their payment is correct before the event. So please follow the process above.

Thank you for your payment. 🙏
And thank you for your interest and trust in me and my work.🙏
I am looking forward to seeing you there and being in your presence.

I AM Grateful. ☀️☀️☀️
ROGER111