Please read carefully.  By signing this form, you are waiving all rights to compensation in case of injury

I the undersigned do acknowledge that there is inherent risk involved when participating in or engaging in a seminar which involves walking across burning embers.  I declare that I am of sound mind and do relinquish from liability in any way shape or form from me or any party acting for me, Success Formulae Limited, its Directors, associated companies, suppliers, employees or associated staff both now, or at any time in the future from any injury done by me or to me of whatsoever nature during my participation in this course.

I declare that I am participating in the Firewalking Instructor Training and Empowerment Intensive seminar of my own free will, voluntarily, and at my own risk and I also understand that no assurance guaranteeing my safety is being made.

By signing this release form I acknowledge that I have been informed that people have been seriously injured by participating in firewalking and/ or glasswalking/ type seminars and that there is inherent risk in these types of activities and that if I voluntarily choose to firewalk, or partake in any of the activities whilst here, there is a possibility that I might receive injuries requiring medical attention.

I understand that this is a world-wide agreement and whilst I agree to its terms whilst in one country, I agree to be bound by its terms globally.

I agree not to bring any suit for damages regardless of whether negligence can be demonstrated and I release all parties associated with this event from any damages suffered by me whether mental, physical or financial.

I understand fully that I am solely responsible for all my choices during the event, and that I have the right to refuse participation in any or all the activities at any time during the seminar  and have been advised of the dangers and warned against the intake of intoxicating materials.

I certify that I have no physical conditions which may inhibit healing, such as diabetes, auto-immune diseases, or any other medical condition which might adversely affect my physical and / or mental wellbeing in the event of injury.  I further affirm that I do not desire to inflict harm upon myself.

I CONFIRM THAT I AM NOT BEING TRAINED TO TEACH AND CERTIFY FIREWALKING INSTRUCTORS.

I acknowledge that I am being offered proprietary information and I respect and agree not to impinge any Intellectual Property by using the information that I have been provided to train attendees of my courses to a level which would allow them to call themselves firewalking instructors, or any such similar title, which might allow them to provide firewalking or empowerment seminars.  I understand that Success Formulae and The Firewalking Center offer advanced courses and ongoing supervision that would allow me to train to the level of Master Instructor and thereafter certify delegates to the level of Firewalking Instructor and I agree to compensate Success Formulae for the full fees associated with Mastery Certification, should I breach the terms of this clause. This agreement is a worldwide agreement.

I understand and agree to allow the capture of my image and voice either directly or indirectly during my participation during the course and agree that this may appear on video, audio, or any other media means that Success Formulae Limited, and all associated companies may require, including presentation, promotion, or advertising

By electronically signing & submitting this form, I release any and all claim(s) I may have while attending this event.  I am knowingly and voluntarily assuming any and all risks of injury including death, and am knowingly and voluntarily signing this release form.  This release extends to all parties, directly and indirectly associated with this course, including Steve Consalvez, their associated companies and neighbours and any other volunteers, staff and other participants in the Firewalk Instructor Training.

By ticking that I agree below specifies that I have read and understood everything contained in this waiver and assumption of risk form.  I have read this entire Release Form and fully understand its contents and agree to be legally bound by its terms.

I understand that The Firewalking Instructor Training Certification programme, is an intensive experiential programme designed to teach the possibilities of human potential and as such I understand that this seminar’s activities may be extremely challenging and are designed to both help me with instruction and help me empathise with my own delegates.