Today's Date *

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Name *

First Name

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Date of Birth *

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Contact Telephone *

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Address 2

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I confirm that am over 18 years of age

YES

Declaration *

1: We reserve the right to refuse our services to anyone without explanation 2: If a client has any contraindication, we reserve the right to not work with them. 3: If a session/course is canceled less than 48 hours before the session, no refund will be given unless under extreme services, no refunds will be given at all only a credit note under exceptional circumstances 4: We expect all clients to agree to our disclaimer before we work with them. 5: Ajooni Ltd are not accountable for any results or effects you may or may not get through Kambo and our Kambo sessions. 6. Any cancellations before 48 hours will receive a 50% refund I have been fully informed about my therapy including the method of treatment and agree to willingly undertake to receive the treatment offered by Ajooni Ltd. I agree to continue to take any medication prescribed by my doctor and will not discontinue any medication without my doctor’s consent. I agree to follow all instructions given to by the practitioners and return for further treatments as suggested by the clinic. If required, I agree to stay in contact with the Ajooni Retreat via telephone, email or in person, if I have any questions regarding my therapy. No guarantee has been given that I will not relapse. For medical advice, I will consult my doctor. I agree to all terms and conditions.

I have read and agree to the terms above.

Disclaimer *

I understand that the Ajooni practitioners are not medical doctors, nor any other form of the medical practitioner. I understand that the Ajooni practitioners do not diagnose disease, offer health advice, treat physical or mental health issues, or prescribe medicine or pharmaceuticals. I understand that any complementary therapy treatment which I receive is not a substitute for a medical or psychological diagnosis or treatment by a qualified medical practitioner. I understand that it is recommended that I see such a practitioner for any physical or psychological problem I have now or in the future. I further confirm that all the details provided are true and accurate. I understand that everyone’s Kambo experience is different and that although Kambo has created outstanding results for other people, Ajooni Ltd cannot guarantee any results. I understand that Kambo fertility success rates differ from person to person and that it may not work for me. I hereby release Ajooni Ltd from all liability resulting from the use of equipment, materials, preparations, remedies, or treatments and assume full responsibility for all risks regarding this treatment. No refunds will be given when a cancellation is less than 48hrs before, only under exceptional circumstances will a credit note be given.

I have read and agree to the terms above.