Beneath the Noise Registration

Please fill in the form below to complete your registration.

IMPORTANT!

Each participant MUST register with their own email address and personally sign the

Event Participation Waver

First Name *

Last Name *

Phone *

Email *

Address

Street Address

City

State

Country

Postal Code

Date of birth *

Emergency Contact *

Emergency Contact Phone Number *

How did you hear about us?

Event Participation Waiver *

By checking this box, I acknowledge that I have read and agree to the following:

By booking and participating in any service at The Retreat at Canyon Ridge, LLC (17825 S. Western St., Canyon, TX 79015), including but not limited to Somatic Breathwork or use of the Quantum Energy Wellness Bed ("QEWB"), you ("Client") acknowledge and agree to the following: You affirm that you are at least 18 years of age and legally competent to enter this agreement, or that you are the parent or legal guardian of a minor and have full authority to consent on their behalf. You understand that participation in wellness sessions, including use of the QEWB or Somatic Breathwork, involves inherent risks that could result in physical, emotional, or psychological injury, illness, or damage to property, and you voluntarily assume all such risks. You acknowledge that no specific results are guaranteed and outcomes may vary. You understand that services at The Retreat at Canyon Ridge are not medical treatments and are not intended to diagnose, treat, cure, or prevent any medical or psychological condition — they are for wellness and relaxation purposes only and do not replace the advice, diagnosis, or treatment of a licensed healthcare professional; you agree to consult your physician regarding any medical concerns prior to participating. You hereby fully and forever release and discharge The Retreat at Canyon Ridge, LLC, its owners, members, managers, employees, contractors, agents, successors, and assigns from any and all claims, demands, or causes of action related to your participation, including those arising from negligence, and agree to indemnify and hold them harmless from any liability, loss, or expense (including attorney's fees) arising out of your participation. You accept entry to the property "as is" and understand that the Released Parties are not responsible for hazards such as uneven ground, wildlife, structures, wet floors, or equipment. You agree to treat the property, staff, and other guests with respect and to refrain from causing damage or engaging in disruptive behavior. This agreement is governed by the laws of the State of Texas, with venue proper only in Randall County, Texas. You also acknowledge that photographs, video, and audio may be captured during your visit and grant The Retreat at Canyon Ridge, LLC a non-exclusive, royalty-free, perpetual license to use such media for promotional, marketing, and educational purposes — including websites, social media, and print materials — without compensation. You waive any right to inspect or approve finished media. If you wish to opt out of photography and recording, you must notify staff in writing at the time of check-in. By proceeding with your booking, you confirm that you have read, understood, and voluntarily agree to all of the above.

By checking this box, I agree to receive text messages from Susan Roberson Coaching (SRoberson Enterprises, LLC) related to appointments, services, and account-related notifications. Message frequency varies. Message & data rates may apply. Reply STOP to opt out or HELP for assistance. Consent is not a condition of purchase. View our Privacy Policy and Terms of Use.