SHAWN WICKS "THE DIABETIC FIGHTER" RELEASE OF LIABILITY FOR RECEIPT OF NUTRITION INFORMATION AND WAIVER OF CLAIMS ARISING FROM RECEIPT OF NUTRITION INFORMATION Disclaimer The nutrition information provided by Shawn Wicks is designed for and solely intended to be suggestions which may voluntary be implemented into the diet of the person whose signature appears below (“the client”). Use of any nutrition information provided is completely voluntary and each user is solely responsible for their voluntary choice to implement the dietary suggestions. It is the sole responsibility of the client to provide complete and accurate information. Any misinformation or omitted information may affect the nutritional assessment or advice. Any misrepresented information is solely the client’s responsibility and Shawn Wicks will not be liable. Shawn Wicks provides nutrition consulting and recommendations only and is not licensed to diagnose a medical condition or illness. The client must consult a physician for any medical advice. Waiver and Covenant Not to Take Legal Action I have volunteered to participate in a wellness program under the direction of Shawn Wicks, which will include, but may not be limited to nutritional planning. In consideration of Shawn Wicks agreement to assist me, I do here and forever release and discharge and hereby hold harmless Shawn Wicks and his/her respective agents, heirs, assigns, contractors, and employees from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in any nutrition program including any injuries resulting there from. Assumption of Risk Shawn Wicks recommends you consult your physician before undertaking any diet or exercise program. By implementing the suggestions provided by Shawn Wicks, the client is affirming that she or he has consulted with a medical doctor and has been cleared to implement the suggestions. Any nutrition information provided is not intended to diagnose, treat, cure or prevent any type of disease or condition. If you need specialized dietary planning to treat, cure, or prevent any type of disease or condition, you should consult with your medical doctor. If I am pregnant or lactating, have high cholesterol, high blood pressure, high blood sugar, diabetes, renal disease, have had gastric bypass surgery, or currently have (or have had in the past) any other medical condition that 1 requires special dietary restrictions, I must receive permission from my physician before participating in the wellness program, or may be advised to seek help from another health professional. I recognize that specific foods may create allergic and possible fatal reactions. I have therefore specified any food allergies/sensitivities I am aware of on the client intake form. I am aware that specific foods may interact with certain medications. I have therefore specified all prescription and OTC medications on the client intake form, and have discussed the side effects of all of my medications with my doctor or pharmacist. I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this wellness program. I understand that results are individual and may vary.