ADULT PARTICIPATION AGREEMENT

Education, Coaching, Wellness, Classes & Events

Informed consent, scope of services, assumption of risk and limited release for participants age 18 or older.

This form is for adults only. A parent or legal guardian must complete a separate minor form before anyone under 18 participates. This agreement does not authorize photography, recording, interviews or publication; those require a separate media release.

Participant Information

Full legal name *Date of birth *Email *Phone *

Program, class or event name *

Emergency contact name *Emergency contact phone *

Activities Covered by This Agreement

Select every activity you may participate in. Selecting an activity does not obligate you to participate.

Life coaching, goal setting and accountabilityTrauma-informed education, reflection or personal-growth exercisesHolistic wellness education, meditation or breath-awareness practicesGeneral food, nutrition or healthy-lifestyle educationOptional movement, stretching, fitness or outdoor activityLive or online class, workshop, meetup, fundraiser or community event

Important Scope of Services

Mission Novakai provides education and coaching—not licensed healthcare. Unless a presenter separately identifies their current professional license and acts within that license, Mission Novakai, its life coaches, volunteers, speakers and peer facilitators are not acting as physicians, psychiatrists, psychologists, psychotherapists, licensed mental-health counselors, dietitians, nutritionists, nurses or other healthcare professionals.

Services do not diagnose, prevent, treat or cure any physical or mental condition.
Coaching and classes are not psychotherapy, crisis care, medical care or a substitute for licensed professional treatment.
Food, supplement, holistic-health and lifestyle information is general education drawn from sources and experience; it is not an individualized prescription, medical nutrition therapy or a promise of results.
Do not stop medication, therapy, medical treatment or a prescribed diet based on a Mission Novakai activity. Consult an appropriately licensed professional about personal decisions.
No specific outcome, healing, cure, income, relationship result or transformation is guaranteed.

I understand and accept the scope above. *Initials *

Trauma, Emotional Safety and Crisis Limits

Reflection on painful experiences may bring sadness, anger, anxiety, memories, discomfort or other strong emotions. I control what I share, may decline any exercise or question, and may pause or leave at any time. Mission Novakai does not require disclosure of private trauma details.

Individual information will be handled as described in the Privacy Policy, but group participants cannot be guaranteed to keep information confidential. Mission Novakai may act or disclose information when reasonably necessary for an emergency, safety concern, suspected abuse, or as required by law.

Not an emergency or crisis service. If I may harm myself or someone else, or need urgent medical or psychiatric help, I will call 911, call or text 988, or go to the nearest emergency department rather than relying on Mission Novakai.

I understand the emotional risks and crisis limitations. *Initials *

Health, Food, Movement and Personal Responsibility

I will use my own judgment, disclose relevant limitations privately when appropriate, follow safety directions and stop any activity that feels unsafe. I understand that food, supplements, breath practices, movement, events and facilities may involve risks such as allergic reaction, medication interaction, dizziness, emotional distress, falls, strains, illness, travel or other injury. I am responsible for checking ingredients and seeking qualified medical advice when I have allergies, pregnancy, chronic conditions, medications or other concerns.

Mission Novakai does not provide emergency medical insurance. I authorize reasonable emergency assistance if I cannot consent, understand that no particular response is guaranteed, and accept responsibility for expenses charged by outside providers.

I understand these health and activity risks. *Initials *

Voluntary Participation, Assumption of Risk and Limited Release

Voluntary choice. Participation is voluntary. I may ask questions, skip an activity or withdraw, although withdrawal does not erase obligations or records already created.

Assumption of inherent risks. I knowingly accept the ordinary and reasonably foreseeable inherent risks of the activities I select, including risks described above and risks arising from my own decisions, condition or failure to follow instructions.

Limited release. To the fullest extent Florida law permits, I release and hold harmless Novakai Inc, doing business publicly as Mission Novakai, and its directors, officers, employees, volunteers, facilitators and authorized agents from claims for ordinary negligence arising directly from my voluntary participation in the selected activities. This release does not waive claims that cannot lawfully be waived, and does not release gross negligence, reckless or intentional misconduct, fraud, unlawful conduct, or conduct outside the scope of the activity.

Participant conduct. I will follow safety rules, respect boundaries and property, and not harass, threaten or intentionally harm others. Mission Novakai may refuse or end participation for safety or conduct reasons.

Florida law; severability. Florida law governs. If one provision is unenforceable, the remaining provisions continue to the fullest extent permitted. This form is the participation agreement; separate written agreements control media use, employment, professional services, purchases or venue/vendor matters.

I am at least 18 years old and legally able to sign for myself. *I read this entire agreement, had the opportunity to ask questions, understand it and voluntarily agree. *I consent to electronic records and signatures and intend my electronic signature to have the same effect as a handwritten signature. *

Electronic Signature

Type full legal name *Draw signature with your finger, stylus or mouse *

Signature required

Signing date

The signed record and encrypted signature are stored privately for Mission Novakai administration. See the Privacy Policy. This agreement is not a media release.