Health Declaration Form

Kindly read and understand this declaration statement prior to signing it. You must complete this health declaration form to subscribe our online course(s), workshop(s), program(s) and/or any other products, services and/or packages provided by Om Space (“the Courses”). If you are a minor, you must have this declaration signed by your parents or legal guardian.

The purpose of this Health Declaration is to ensure that you are medically fit to join any of our Courses. In any event that you were diagnosed physically and/or mentally unhealthy and/or unfit, it is advisable that you must seek medical assistance prior to participating the Courses and we shall request for a copy of the medical and/or specialist report prior to granting the permission for you to attend the Courses.

I hereby declare and agree that on the day of signing of this declaration:-
1. I am physically and/or mentally sound and/or fit to attend the Courses;
2. I have not taken up any hazardous occupation neither I have suffered any illness / disease requiring treatment for more than one (1) week;
3. I will declare my mental and physical health situation immediately to Om Space if any of my mental and physical health issues were diagnosed after signing of this Health declaration;
4. I will not cause any violence, trouble and/or any form of chaos during the participation of the Courses; and
5. I shall withdraw or Om Space shall be authorized to withdraw and/or stop my participation in the Courses immediately if I were diagnosed as physically and/or mentally unfit and I understand that all fees and/or payment paid by me or my parents or my legal guardian (as the case maybe) shall not be refundable.

I hereby understand and acknowledge that:-
1. In the event any unforeseeable situation or incident occurred during the Courses due to my unstable physical or mental state, I agree that Om Space has the right to refuse and/or deny my participation in the Courses;
2. Om Space will not and shall not guarantee any positive and success result from the Courses that I have attended and the result shall be depending on my own involvement, attitude, willingness to participate and other positive deeds that shall be maintained by myself during the participation during the Courses;
3. Om Space shall not be liable for any violence and/or trouble and/or chaos during the Courses that caused by unhealthy mental state of me and/or other participants.

I declare that the information provided herein above is accurate and to the best of my knowledge. I agree to accept any responsibility for any omissions in disclosing my existing or past physical and/or mental health conditions.

I further state that I have duly read and understand this Health Declaration Form and the consequences by accepting the same and agree to be bound by the terms herein.

Consent and Release Form

I, hereby grant permission and authorization to Om Space Sdn. Bhd. (“hereinafter referred as “Om Space”) the rights and permissions to publish, reproduce or otherwise use of my photos, images, videos, recordings and/or any audio-visual recordings without payment of consideration to me (“the Materials”).

I acknowledge and understand the Materials may be used for commercial and/or non-commercial purposes including but not limited to education, training and consultation activities, marketing and promotion of the course, program, therapy and consultation practice.

I understand that the Materials may be edited, copied, exhibited, published and/or distributed. I also understand the Materials may be used individually or in conjunction with other media in any medium, including without limitation to print publications, digital publications, and/or public broadcast for any lawful purpose within the nature of business of Om Space. There is no time limit on the validity of this release nor are there any geographic limitations on where the Materials may be distributed.

I hereby agree and grant Om Space including its employees, agents, licensees, successors, and/or any third-party organizations all ownership rights and irrevocable right and permission to use, publish, sell, distribute, and/or promote the Materials.

I understand that my participation is voluntary and that I may, at any time, discontinue my involvement before signing this document subject to the Om Space’s Return and Refund Policy.

I understand that I shall take full responsibility for my subscription and/or participation in any of the course, workshop and/or therapy session(s) and the risks that it may entail (be that legal, physical, or mental) and release Om Space from any claims, demands, losses, damages, suits, and liabilities of any kind whatsoever in connection with the foregoing.

I hereby certify that I am above eighteen (18) years of age and am competent to contract in my own name in so far as the above is concerned. If I am below eighteen (18) years old, my parents or legal guardians have read this document and have given their consent by signing below.

By signing this form, I acknowledge that I have completely read and fully understand the above Consent and Release Form and are agreeable to be bound thereby. I hereby release and waive any and all claims against any person or organization utilizing the Materials for marketing, educational, promotional, and/or any other lawful purpose whatsoever.