Terms & Conditions - Medical Booking Form

Terms & Conditions

In consideration of the mutual benefits which are expected to arise out of the activities which I intend to engage in under the sponsorship of Monroe Institute, and especially of the benefits, educational and otherwise, which I expect to derive, I hereby release and forever discharge the Monroe Institute and all officers, directors, employees, agents, representatives and/or volunteers and the successors of either from all claims and demands whatsoever which I, my heirs, executors, administrators and assigns have, or may have, against them by reason of any physical injury and mental and emotional issues of any nature whatsoever which I might suffer during or after my participation in the Program, my participation in any research conducted by Monroe during the program, my use of their facilities, Yoga instruction, Lake Miranon and/or the swimming pool, and I hereby expressly declare that any such activities are entered into by me voluntarily in an effort to increase my knowledge of the subjects under investigation.

I understand that, during the course of my program, there may be disclosed to me certain trade secrets of Monroe, including methods, processes, formulae, compositions, inventions, machines, computer programs and information regarding research projects and/or the results thereof. I shall not, during or at any time after the termination of my affiliation with Monroe, use for myself or others, or disclose or divulge to others, any such trade secrets, confidential information, or any other data or materials of Monroe without prior permission. Any participant found to be taping, filming or in any such manner recording any part of their Monroe program content may be subject to legal consequence.

I understand that the materials presented by Monroe Institute in this program are intended solely for use by program participants. I will not use the materials for any purpose other than my own personal use and agree not to copy, resell, reproduce and sell, modify and sell, or repackage and sell the materials.

I represent that I have not registered in the Program to handle a physical, mental or emotional problem. Further, I know of no recurring symptoms, physical or mental, which suggest to me that I may not be able to handle the types of activities described to me as part of the Program.

Use of alcohol, marijuana and/or any other illicit substances is not permitted at any Monroe residential programs. Should the use of alcohol or other drugs become a disruption to the group, participants will be asked to leave the program.

I agree to the above terms and conditions and certify that the answers given by me on this application are true and complete to the best of my knowledge. I also agree to advise the Monroe Institute registrar, if between the time I send in this form and the time my program begins, I experience any alteration in health or my mental condition that would affect my answers on this application.