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Mind & Life Institute - Dharamsala Conversation 2022

WAIVER OF LIABILITY AND AUTHORIZATION FOR MEDICAL TREATMENT

I voluntarily agree to participate in activities sponsored by the Mind & Life Institute, Inc., a Virginia non-profit corporation, in connection with the Mind & Life Institute’s Conversation in Dharamsala, India with His Holiness the Dalai Lama (“Dharamsala Conversation”). This Waiver of Liability and Authorization for Medical Treatment includes the actual Conversation with His Holiness and the surrounding dates of optional activities in Dharamsala, India, plus the pre-event and post-event travel days in Delhi, India. Dates span October 7-17, 2022.

I realize that my participation in all activities sponsored by the Mind & Life Institute is voluntary and entirely at my discretion. I hereby assume all risks of injury to me, which may be sustained while participating in the events sponsored by the Mind & Life Institute. I also release the Mind & Life Institute of any responsibility for any of my property that may be lost, stolen, or damaged while attending the Conversation with His Holiness events in Dharamsala and Delhi, India.

I agree that in the event of a medical or psychological emergency, the Mind & Life Institute has the sole authority and sole discretion to contact 911 emergency services, as well as my designated emergency contact person. I understand that the Conversation with His Holiness is a conference held in Dharamsala, India and the Mind & Life Institute is not expected to provide medical and/or psychological care while I am a participant at the Conversation. Any costs incurred for the provision of health services are my responsibility and not the responsibility of the Mind & Life Institute. I understand that the Mind & Life Institute staff will make every reasonable effort to communicate with my designated contact person in the case of an emergency.

I further understand that participation in the Conversation is at the discretion of the Mind & Life Institute and, if in the opinion of the Mind & Life Institute, I am unable to participate appropriately in such activities, I may be asked to leave.

I have read this agreement and fully understand its contents. I sign it of my own free will. I am of full age and accept the above disclaimer and authorization.

In the event any portion of this instrument shall be declared invalid, unenforceable, or void by a court of competent jurisdiction, then the remaining provisions of this instrument shall remain in full force and effect.

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June 18, 2019 11:40 am EDT

Mind & Life Institute - Dharamsala Conversation 2022 Uploaded by Mind & Life Institute - e-signatures@mindandlife.org IP 172.103.75.30