I, for and in consideration of this service which is hereby acknowledged, do hereby release and forever discharge Becki Siconolfi, Shawn Bean, Live Healthy With Becki, Vivre Sano, Matrix Health and Wellness and any and all persons, firms or corporations liable or who might be claimed to be liable, whether or not herein named, none of whom admit any liability to the undersigned, but all expressly denying liability, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, which I now have or may hereafter have, arising out of or in any way relating to any and all injuries and damages of any and every kind, to both person and property, and also any and all injuries and damages that may develop in the future, as a result of or in any way relating to this coaching service.

I furthermore understand and agree that any no-call/no-show will result in the forfeit of all monies paid. In the case of a late cancellation, defined as a cancellation less than 24 hours in advance of the scheduled session, I understand that I will only receive a 50% refund of the purchase price. In the case of cancellation of an appointment 1 hour prior to the start of the appointment will result in full forfeit of all monies paid. 

I also understand if I am greater than 5 minutes late to the appointment that it will be canceled, and I have 1 opportunity to reschedule it before the full fee is forfeited. It is understood and agreed that this release shall be binding upon me, and my respective heirs, executors, administrators, personal representatives, successors, and assigns. This release shall be subject to and governed by the laws of the State of Pennsylvania.

I hereby agree to the above legalese, and I understand that by checking the boxes, it is the equivalent of a signature and that it is legally binding me to this agreement.