REGISTRATION FORM

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Please provide 3 Dates (ex. 01/01/2016) and Times (ex. 5pm) in which you wish to have your Consultation? *

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Please list the health opportunities you wish to resolve or any symptoms you would like to address. *

LIABILITY RELEASE AGREEMENT: I understand that the program, advice from health coaches, and content on this website are not intended as a substitute for medical counseling or consultation. I know that I should consult my personal physician before starting this program or any other diet, fitness, or health cleanse program. I understand the statements on this site have not been approved or evaluated by the Food and Drug Administration. I understand the program is not intended to diagnose, treat, cure or prevent any disease. The Raw Oasis Health Inc. For Members and Participants of the club, program & events provided by The Raw Oasis Health Inc. (dba. The Raw Oasis) The Raw Oasis Health Inc., doing business as, The Raw Oasis, is a private club organization dedicated to providing support and organized social networks for members that wish to voluntarily participate in a raw food based cleanse program. The Raw Oasis Health Inc. is a private club, were membership by “club members” is strictly voluntarily. A “club member” is any participant of any event or service offered by The Raw Oasis Health Inc. Therefore, all participating club members assume total responsibility for their actions and health conditions as it relates to the cleanse (health cleanse) program including actions that pertain to support group sessions or actions taken by advice & information obtained by Raw Oasis Health Inc. associates, owners, employees, contractors, and fellow members. By signing this form I, as a consumer of The Raw Oasis Health Inc. club membership, events and services, agree to all statements above as well as the following statements. I am willing to share, in accordance to my own discretion, with those affiliated with, including associates, owners, employees, contractors, and fellow members of The Raw Oasis Health Inc. to discuss openly and freely of my health issues and solutions to these issues between each other, as I deem acceptable. I fully understand that anyone I speak with associated with the Raw Oasis Health Inc., including associates, owners, employees, contractors, and fellow members of The Raw Oasis Health Inc., are not medical doctors nor licensed medical practitioners of any kind. I am not participating in this group as a substitute for medical diagnostic, medical consoling, or treatment procedures. I fully understand that The Raw Oasis Health Inc. advises that I seek professional medical consultation before starting any program that changes my current diet or exercise program. I agree that all the diet, nutritional, herbal, homeopathic, fasting, and any other health information and suggestions provided by any associates, owners, employees, contractors, and fellow members of the Raw Oasis Health Inc., are for my personal information only. If I follow any of the information received, I do so based on my own behalf and on my own decisions based on my personal belief. I take full responsibility for my actions and the results of these actions. I agree that if I use any information to treat a medical condition without my medical doctor’s approval, I am prescribing for myself and exercising my Constitutional Rights. I fully agree to hold harmless, any associated organizations of The Raw Oasis Health Inc. and any of their members, for any information, actions, or consultation that relates to the cleanse program and activities of The Raw Oasis Health Inc. I agree that any information as I have disclosed or discussed with any associates, owners, employees, contractors, and fellow members of the Raw Oasis Health Inc. that relate to my health is at all times limited strictly for my educational purposes and only on the subject of health matters. This information is not intended for the diagnosing, prognosticating, treatment, or prescribing of remedies for the treatment of disease. This agreement is to establish a mutual trust, relationship, and understanding. Therefore, by my acceptance on the www.therawoasis.com website when I signed up for The Raw Oasis membership and program, I acknowledge that I have read the above and agree to the terms stated. This affidavit is accepted by me without coercion or remuneration. *

Yes, I have read, understood, and agree to the Liability Agreement.

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