I hereby request to participate in a workshop, training, or retreat led by Educational Design Associates (hereafter referred to as EDA).

In connection with this application, I hereby acknowledge and understand that:

The purpose of this program is to offer movement and dialog-based learning activities to explore self-awareness, meaning-making, and consciousness development.

This workshop will incorporate martial arts strategies, potentially including standing, sitting, and horizontal activities, both alone and in physical contact with others. These activities will be aimed at building awareness and capacity. However, given that they may involve physical interaction between people, there is a potential for physical injury to myself as a participant.

In choosing to take part in a program that involves movement, physical stretching, and partner practice, I acknowledge and accept the existence of a real risk of physical injury to my person. I understand the nature of these risks. Nevertheless, I voluntarily commit myself to undertake this opportunity and assume for myself the risks involved.

I further acknowledge that this workshop delves into personal growth topics that may prove to activate or trigger things within my mental health or psychological development. I commit to taking responsibility for my own experience, including sitting out certain activities or even leaving the workshop, if necessary, in order to preserve my psychological wellbeing.

I have read this Risk Release, Consent, & Assumption of Risk Statement and agree that it covers any and all program activities sponsored by EDA, its agents, employees, or instructors, whatever the location.

I agree to indemnify and hold harmless Educational Design Associates, Daniel Kirkpatrick, any other paid or volunteer staff of EDA, and the owners

of the property in which this program takes place, for acts of commission or omission in the conduct of the program.

I also agree to abide by the guidelines provided by EDA and to explicitly follow all instructions given. I acknowledge that my failure to do so could result in elimination from the program. I also acknowledge that all fees paid to the EDA are non-refundable and non-transferable.

I have read and am OK with all the info in the provided packet.