The following text is lengthy, quite technical and detailed. It is based on Talmudic concepts, and is constructed, in Jewish "legalese," to cover all relevant topics. The petitioner begins by addressing the Beit Din as follows:
Listen, please, my masters, expert judges -- every vow or oath or prohibition, or prohibition that I adopted by use of the slang term 'konam' or the term 'cherem'; that I vowed or swore while I was awake or in a dream; or that I swore by means of God's Holy Names that it is forbidden to erase or by means of the Name HASHEM ("HASHEM" is not the Name of G-d that is actually mentioned here), Blessed is He; or any form of nazirism (see "NAZIR" in Glossary) that I accepted upon myself, except the nazirism of Samson [which does not include a prohibition against contact with the dead]; or any prohibition, even a prohibition to derive enjoyment that I imposed upon myself or upon others by means of any expression of prohibition, whether by specifying the term 'prohibition' or by use of the terms 'konam' or 'cherem'; or any commitment -- even to perform a mitzvah -- that I accepted upon myself, whether the acceptance was in terms of a vow, a voluntary gift, an oath, nazirism, or by means of any other sort of expression, or whether it was made final through a handshake; any form of vow or voluntary gift, or any custom that constitutes a good deed to which I have accustomed myself; and any utterance that escaped my mouth or that I vowed in my heart to perform any of the various optional good deeds, or good practices, or any good thing that I have performed three times but without specifying that the practice does not have the force of a vow; whether the thing l did related to myself or to others; both regarding vows that are known to me and those that I have already forgotten -- regarding all of them I regret retroactively and I ask and request of your eminences an annulment of them. [My reason is that] I am fearful that I will stumble and become entrapped, Heaven forbid, in the sin of vows, oaths, nazirism, cherems, prohibitions, konams, and [violation of agreements].
I do not regret, Heaven forbid, the performance of the good deeds I have done, rather I regret only having accepted them upon myself with an expression of a vow or oath or nazirism or prohibition or cherem or konam or agreement or acceptance in my heart, and I regret not having said, 'Behold I do this without [adopting it in terms of] a vow, oath, nazirism, cherem, prohibition, konam, or acceptance in my heart.
Therefore, I request annulment for them all. I regret all the aforementioned, whether they were matters relating to money, or whether they were matters relating to the body or whether they were matters relating to the soul. Regarding them all, I regret the terminology of vow, oath, nazirism, prohibition, cherem, konam and acceptance in the heart. Now behold, according to the law, one who regrets and seeks annulment must specify the vow, but please be informed, my masters, that it is impossible to specify them because they are many. Nor do I seek annulment of those vows that cannot be annulled, therefore may you consider as if I had specified them.
The judges repeat three times:
May everything be permitted you, may everything be forgiven you, may everything be allowed you. There does not exist any vow, oath, nazirism, cherem, prohibition, konam, ostracism, excommunication, or curse. But there does exist pardon, forgiveness, and atonement. And just as the earthly court permits them, so may they be permitted in the Heavenly Court.
The petitioner makes the following declarartion:
Behold, I make formal declaration before you and I cancel from this time onward all vows and all oaths, nazirism, prohibitions, konams, cherems, agreements, and acceptances of the heart that I myself will accept upon myself, whether while I am awake or in a dream, except for vows to fast that I undertake during Minchah. In case I forget the conditions of this declaration and I make a vow from this day onward, from this moment I retroactively regret them and declare of them that they are all totally null and void, without effect and without validity, and they shall not take effect at all. Regarding them all, I regret them from this time and forever.