Spa Consent Form
Guest Name
Phone Number
Address
Email
Date of Birth
Emergency Contact Name
Emergency Contact Phone
By signing this Spa Release of Liability and Waiver, I am confirming that I recognize that there may be inherent risks associated with using certain equipment, utilizing, The XXX Spa (“the Spa”) facilities, participating in programs and/or receiving treatments at the Spa.I acknowledge and agree that I am responsible for my own health; that the Spa associates and/or technicians are not health care practitioners and cannot be expected to diagnose and/or treat individual health problems.I understand that I am responsible for discussing any questions that I may have concerning my health conditions (if any) throughout any program or treatment at the Spa and, should health-related symptoms occur I will cease my participation and inform the Spa personnel of the symptoms.In the event that I have reason to believe that medical clearance must be obtained prior to participation in any Spa treatments, therapies, steam, facials, nail or hair treatments, or facility equipment, I agree to first consult a physician and obtain written permission from a physician prior to the commencement of any program, treatment, or activity.By voluntarily choosing to receive Spa-related treatments and/or participate in Spa-related activities and programs, I warrant that to the best of my knowledge, I have no disability, impairment, or ailment that prevents me from receiving such treatments and/or engaging in such participation.Consequently, in light of the foregoing, I hereby release the Spa and its affiliates, owners, members, officers, employees, agents, successors and assigns and waive any and all claims, liabilities, property damages, physical damages or personal injuries that I may receive directly or indirectly from receiving Spa related treatments, utilizing the Spa facilities and/or participating in the programs or activities offered by the Spa.
Guest Signature