Please read the following Terms & Conditions and complete the form below.
Golden Slumber, its officers, agents, employees and associates, do not diagnose or treat disease. You should consult a Physician for diagnosis for any and all suspected health issues that you and/or your baby might have before undergoing any sleep counseling or training. Any recommendations you follow regarding sleep for your child, yourself or members of your family are entirely your responsibility.
In agreeing to work with Golden Slumber, I hereby affirm that I am the parent or court appointed guardian of the child for who sleep counseling is being sought. As such, I accept all risk of injury or death to myself or my child that might result from such participation and hereby release Golden Slumber, it’s officers, agents, employees and associates, from any liability to me, my child, my personal representatives, estate, heirs, next of kin and assigns for any and all claims and causes of action for loss of or damage to my property and for any and all illness or injury to myself or my child including death, that may result from or occur during my participation in sleep training and/or sleep counseling, whether caused by negligence of Golden Slumber, its officers, agents, employees, and associates or otherwise. My participation in sleep counseling/sleep training is strictly voluntary, no one is forcing me to participate and I elect to participate in spite of the risks.
I further agree to indemnify and hold harmless Golden Slumber, its officers, agents and employees and associates from liability for the injury or death of any person(s) and damage to property that may result from my acts or omissions while participating in the described and agreed upon sleep counseling/training session(s). This includes causes which are known or unknown, specifically mentioned or implied, or not mentioned nor implied, which might exist or be claimed to exist at or prior to the date of this document. The undersigned further specifically waives any claims or right to assert that any cause of action or claim or demand has been, through oversight or error, intentionally or unintentionally omitted from this release. The undersigned also understands that Golden Slumber, its officers, agents, employees and associates provide sleep counseling, sleep education and sleep training, but is not state licensed. Also, when the term “counseling” or “counselor” is mentioned above it does not refer to psychological, state licensed professional, psychiatric or clinical advice.
I certify that I am fully capable of participating in sleep counseling/sleep education and I have informed Golden Slumber in writing of any medical problems or disabilities me, or my child, may have. Therefore, I assume full responsibility for myself and any child for whom sleep counseling and sleep training is being sought, for bodily injury, death, loss of personal property and expenses (including all medical expenses) thereof a result of those inherent risks and/or my participation in sleep counseling/sleep training.
I have read, understood and accepted the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon me, my heirs, assigns, personal representatives, estate and all members of my family.