Relationship Technologies LLC

D/B/A “Mama Gena’s School of Womanly Arts”

Waiver and Agreement

1. Majority Status: I certify that I am 18 years of age or older.
2. Physical Status: I state that I am physically and mentally of sound mind and body and that I do not currently take any medication that might affect my capacity to enter into this agreement or to participate in any activity, program or course (each, a “Course”) involving Relationship Technologies LLC D/B/A “Mama Gena’s School of Womanly Arts” (hereinafter referred to as “MGSWA”).
3. Confidentiality: I acknowledge that the identities of any and all participants in any Course shall be maintained in total confidence, and I agree that I will not disclose any such information to any third party. I acknowledge any breach of this Confidentiality provision will constitute a material breach of this agreement. I also agree that I will not use any names, addresses, telephone numbers or e-mail addresses I receive from MGSWA in any capacity, including without limitation, a Course, in any manner or for any purpose other than in connection with MGSWA.
4. Personal Representations: I acknowledge and agree that the Courses are educational and are not therapeutic in design, intent or methodology and are not a substitute for medical, psychological or psychiatric treatment, psychotherapy, or any other medical treatment or program health program. The Courses do not address physical, mental or emotional health issues that are best dealt with by physicians, psychotherapists, or other health professionals. You are responsible for your health and well being at all times during any Course and while on the MGSWA premises. I acknowledge that some participants may find Courses emotionally and even physically challenging, and that they may possibly be physically, mentally and emotionally taxing. I acknowledge that MGSWA hereby advises not to take any Course in the event that I am unwilling or unable to meet these physical, emotional and/or mental challenges.
5. Non-Disclosure Agreement: I acknowledge that the information provided by MGSWA is copyrighted, is the property of MGSWA, is not to be used for resale or otherwise and may only be used for my personal use. Any material or information which I acquire or become acquainted with may not be reproduced, copied, distributed, summarized, removed from MGSWA’s premises or otherwise exploited without the prior written consent of MGSWA, in each case. I acknowledge that MGSWA has and shall retain all rights, title and interest in and to the information and material, and no license or right of any kind or nature in or to the information or material is granted. I also acknowledge that Mama Gena may not be physically present at all times during any Course and that additional staff $('input:radio[name=bar]:checked').val()at MGSWA will lead those classes in her stead.
6. Video Agreement: I acknowledge and acknowledge that MGSWA may film, photograph record or otherwise visually and/or audio visually capture (“Film”) the Course(s) in traditional, digital or other formats now known or hereafter devised. This Filming will be primarily of the Course, of the leaders and MGSWA staff, and may include some footage of participants. If I do not wish to be filmed, I acknowledge that it is my responsibility to bring this to the attention of the Course assistants when I am seated so that I can be placed in a way that will not include me in the filming. If private filmed interviews are conducted, I acknowledge that I am under no obligation to be interviewed, and that only participants who give consent will be interviewed on film. However, in the event that I do agree to appear in an MGSWA film in any manner or capacity, I acknowledge that I shall execute the rights release attached hereto in Exhibit A.
7. Arbitration: I agree that any claims, actions, suits or other disputes (the “Disputes”) arising out of my participation in Course and/or involving any employee, representative, officer, worker, or assistant of MGSWA, will be decided by final and binding arbitration before the American Arbitration Association (“AAA”) sitting in New York City. The arbitration will be held before one arbitrator pursuant to the AAA rules. By signing this agreement I am freely giving up my right to a trial by jury and, other than as set forth below, my right to have such Dispute resolved in a court of law. I further agree that, in any proceeding in connection with a Dispute, MGSWA shall be entitled, in addition to damages, unpaid fees, costs and interest, to recover the costs of the arbitration proceedings as well as any collection proceedings, as necessary, including reasonable attorneys’ fees. In the event it shall be necessary to obtain a court order confirming any such arbitral award, or to otherwise bring a court proceeding regarding the Dispute, I hereby irrevocably submit to the jurisdiction of any court of competent jurisdiction sitting in New York City to hear such matter. If any portion of this agreement is invalid it shall not affect the remainder, which shall be construed as though the parties had deleted the invalid portion.
8. Limitation of Liability: I acknowledge that MGSWA is not physically, mentally or emotionally therapeutic or based on medical psychology or psychiatry, in any way. I have chosen to participate of my own free will and take full responsibility for any and all actions that I might take as a result of my participation in the Course(s) and agree that I will not hold MGSWA or any of its subsidiaries, principals, agents, and/or employees liable for any physical, mental, emotional or other damage to myself, any other participant in the Course(s), any third party, or any property that might occur due to my participation in the Course. If I have any questions, I will bring them to a leader of the activity or another representative of MGSWA. If I feel any physical or emotional discomfort during any activity, I will cease such activity immediately and I will inform a leader of such activity or another representative of MGSWA. MGSWA reserves the right to terminate my involvement in this program at any such time and for any reason.
9. Payment: I agree to pay my Course tuition in full, according to the payment schedule agreed to on my payment plan worksheet. I acknowledge that my initial payment(s) is only refundable within seven days after registration. A 10% processing / materials fee will be deducted from all refunds.

EXHIBIT A CONSENT & RELEASE

1. For good and valuable consideration, the sufficiency of which is hereby acknowledged, I hereby grant to Relationship Technologies LLC D/B/A Mama Gena’s School of Womanly Arts (“MGSWA”), its agents and others working for it or on its behalf and their respective licensees, successors and assigns (collectively, “Producer”): (a) the absolute right and permission to interview me; to photograph, film, record and otherwise visually and audio visually capture me in traditional, digital or other formats now in existence or hereafter developed and to so capture my image and voice in connection with a documentary and/or educational and/or promotional motion picture (the “Program”); and to disseminate, distribute, reproduce, publish, exhibit, digitize, broadcast, display, compress, edit, dub, add to, subtract from, modify, combine with other material or otherwise use my voice recording, name, picture, likeness, and biographical information, or any material based upon or derived therefrom, or to refrain from so doing, in any manner or media whatsoever, now known or hereinafter developed, anywhere in the world in perpetuity for any purpose Producer sees fit, including in and in connection with (i) any films, videos, recordings, programs, productions, photographs, computer files, exhibitions or other materials produced by Producer in connection with the Program (collectively, the “Audiovisual Materials”) and (ii) any advertising, promotion, distribution and exploitation of the Program and/or the Audiovisual Materials. (b) all rights, without restriction, exclusively and in perpetuity, in the Program and the Audiovisual Materials, including without limitation, the right to distribute, disseminate or otherwise use the Program and/or the Audiovisual Materials in any media, now known or hereinafter developed, including radio, television, print and the Internet, for any purpose Producer sees fit, including without limitation, promotional activities of any kind.
2. I shall have no right of approval, no claim to compensation and no claim (including, without limitation, claims based upon invasion of privacy, defamation or right of publicity) arising out of any use, alteration, fictionalization, blurring, distortion, faulty reproduction, illusionary effect, or use in any composite form of my name, picture, likeness, voice, and biographical information.
3. I represent and warrant that any statements made by me during my appearance are true, to the best of my knowledge, and that neither my statements nor my appearance will violate or infringe upon the rights of any third party.
4. I acknowledge that Producer is proceeding with the production, distribution of the Program and/or the Audiovisual Materials and any advertising, promotion, publicity or other materials produced in connection with the Program and/or the Audiovisual Materials in reliance upon and induced by my signing this consent and release at substantial cost to Producer and hereby waive any claim of any nature whatsoever against anyone relating to the exercise of the permission granted hereunder. Without limitation to the foregoing, I agree that I shall not have the right to terminate or rescind this consent and release or to enjoin or restrain the distribution, exhibition or exploitation of the Program and/or the Audiovisual Materials or any advertising, promotion, publicity or other materials produced in connection with the Program and/or the Audiovisual Materials.

5. I represent that I am over 18 years of age, and have the full right and authority to grant the rights granted hereunder. I agree that this release does not in any way conflict with any existing commitment on my part.

By selecting "Yes", I agree to the above Consent and Release.