Mists of Erathan

Release Form

Mists of Erathan

Erica Ziegman

360-566-3458

I understand that Erica Ziegman of Mists of Erathan, is a Tarot Reader, Intuitive, and Energy Worker, and does not present herself as a medical doctor nor as possessing any specific or formal medical training, nor as a licensed, registered practioner or counselor.

In consideration of the promises and conditions herein, I seek and it is my intent to hire Erica for Intuitive Consultation and or Energy Work.  As further consideration for Erica’s Services, I agree to provide certain current, complete and accurate information abut myself as required on client forms and verbally during session.  No one representing Mists of Erathan or Erica Ziegman offers me any false hope, false promises, expectations, warranties, or assurances of the success or outcome of any work performed or the information received.

I have read and understood Erica’s fees and that they are paid prior to or at the time of service, and are non-refundable.  I agree to the payment conditions and to pay the total amounts for Erica’s services in US Funds.

If I pay via PayPal, I agree to and authorize that transaction of pay for Erica’s services.  The PayPal web address is www.erathan.com.  Cash is also accepted.

I am eighteen (18) years of age or older, of sound mind, and not under any mind altering substances.  By signing this agreement, I acknowledge that I have read the above, have thoroughly reviewed and understand its contents, and that I am giving my informed consent and it is my intent to agree to this contract.  By my written acceptance of this agreement, I know this document becomes a legally binding contract and is confidential. 

Signature of Client: ______________________________________ Date: ___________ 

Printed Name: ___________________________________

Consent by Legal Guardian, Parent or Power of Attorney:

As the Parent and or Legal Guardian, or POA, I acknowledge that I have read the above, have thoroughly reviewed and understand its contents, and that I am giving my informed consent and it is my intent to agree to this contract.  I authorize you to provide service for _______________________________________ (client).

Signature: ______________________________________ Date: ___________ 

Printed Name: ___________________________________

Relationship to Client: _____________________________