Release of Liability and Informed Consent

I understand that not all who attend this workshop will have the chance to do a personal constellation. However, as the nature of this work depends largely on the shared energy and experience of the group, the movements that take place and resolutions that are found, have meaning for all who participate or observe. The selection of those who set up their own constellation is at the sole discretion of the workshop facilitator(s).

I understand that issues addressed in family constellation work may be of a highly personal and emotional nature. I understand that by participating in this workshop I may experience or observe emotional or physical manifestations related to the presenting issues or the result of previous accident or injury or trauma. I consider myself to have adequate mental, physical and emotional health to be able to accept all such risks. I hereby agree to assume this risk, including, but not limited to the types of responses and manifestations described herein. I understand that my participation is voluntary and that I am responsible to what assess my own level of participation. I also agree to inform the facilitator(s) of any preexisting or current conditions, which may adversely impact my ability to participate in this workshop. I understand that I am free to leave the workshop at any time.

I understand that constellation work is not intended as a substitute for psychotherapy, medical treatment, or for any other professional consultation, but rather, it educational in nature and has been designed to be a process for personal growth. I understand that it is my sole discretionary decision to initiate or cease any other form of therapy. I understand that no guarantee of results or claims of outcome are implied nor stated. I recognize that systemic constellation work, though practiced for more than two decades in Germany and other countries around the world, is still considered to be innovative and that research into its’ long and short term effects is ongoing.

I understand that confidentiality concerning all attendees and their situations as presented in the group is expected and required. I hereby agree to refrain from discussing the work outside of the workshops, except in such a way that each participants’ identity remains confidential. Additionally, I understand that discussing or interpreting the details of my own or another person s’ constellation session following the work is counterproductive and can interrupt the beneficial effects of the work and I shall refrain from such discussions.

My signature below indicates that I have read, understood and agree to the terms of this Informed Consent and Release of Liability. I willingly agree to hold harmless and release from all liability the organizer, the facilitator(s), the staff and my fellow participants, as well as the management and staff of the facility where this workshop is occurring.

Workshop Title: __________________________________________________Date(s): ______________

Facilitator(s)/Presenter(s): _______________________________________________________________

Facilitator(s)/Presenter(s): _______________________________________________________________

Participant Name (Please Print Clearly): ___________________________________________________

Participant Signature: ______________________________________________Date: _______________

Witness Name (Please Print Clearly): _____________________________________________________

Witness Signature: _______________________________________________Date: _________________