Waiver for individual & group life coaching sessions

For certain activities, attendees will be asked to sign a waiver. This is necessary for our insurance.

Participant Agreement, Assumption of Risk & Duty of Care

Provider: Maia Hart

Location: River Haven, Park Lane, Millstream Qld 4888

1. Nature of Activity & Statutory Framework

I understand that life coaching involves conversations, exercises, and reflective practices designed to support personal development. This waiver is entered into voluntarily and is intended to have effect under the Voluntary Assumption of Risk Act 2002 (Qld). I understand that life coaching is not a substitute for medical or psychological diagnosis, treatment, or therapy. The coach does not diagnose, prescribe, or perform medical treatment.

2. Specific Risks of Life Coaching

I understand that life coaching can involve discussion of personal topics and may bring about emotional or psychological responses. The particular risks associated with this activity include, but are not limited to:

- Emotional discomfort, distress, or unexpected psychological responses

- Resurfacing of past experiences or memories

- Changes in personal relationships or circumstances arising from coaching discussions

- Fatigue or mental strain

- Decisions made by me based on coaching conversations are my own responsibility

3. Life or Health Conditions & Who Should Consider Professional Clearance

I understand that life coaching may not be suitable, or may require medical or psychological clearance, if I have any of the following:

- Severe mental health conditions and use of pharmaceutical prescriptions (e.g. psychosis, severe depression, PTSD) where coaching may not be appropriate

- Acute emotional crisis or recent trauma

- Substance dependence or addiction issues

- Recent suicide attempts or suicidal ideation (If I am experiencing suicide attempts or suicidal ideation, I understand I should seek appropriate specialist support services and obtain clearance from a qualified professional before attending coaching.)

- Any condition for which I am currently receiving psychological or psychiatric treatment

- Current or recent experience of domestic violence (If I am experiencing domestic violence, I understand I should seek appropriate specialist support services and obtain clearance from a qualified professional before attending coaching.)

I understand that if I am unsure whether coaching is suitable for me, I should consult my own medical or mental health practitioner before participating.

4. Group Sessions – Additional Acknowledgment

For group sessions, I understand that:

- Other participants may share personal information, and I agree to maintain confidentiality of what is shared by others in the group.

- Group discussions may raise topics or emotions that are unexpected or uncomfortable.

- I am responsible for my own level of participation and may decline to engage in any activity at any time.

- The coach facilitates the group but cannot guarantee the conduct or confidentiality of other participants.

5. My Responsibilities & Disclosure

I confirm that:

- I have read and understood this waiver and I voluntarily assume the risks listed above.

- I am responsible for consulting my own medical or mental health practitioner if I have any doubts about my suitability for coaching.

- I will advise the facilitator before the session if I have any mental health condition, am in crisis, or am receiving psychological or psychiatric treatment that may affect my participation.

- I understand that coaching outcomes depend on my own efforts and that no specific results are guaranteed.

- I understand that I may withdraw from any activity or session at any time.

6. Emergency Authorization

In the event of an emergency, I authorize the provider to seek medical assistance on my behalf.

Participant Signature: ___________________ Date: _______

Print Name: ___________________

Emergency Contact Name & Phone: ___________________

If under 18: Parent/Guardian must also sign.

Parent/Guardian Signature: ___________________ Date: _______

Print Name: ___________________________