USAGE WAIVER AGREEMENT
I, the undersigned, acknowledge, represent, and agree that:
(Checking the box indicates that you agree with the following statements)
I do not have an installed pacemaker or any other implanted electrical device, including, but not limited to, a hearing aid in or attached to my body.
I understand that the Energetic Fitness System equipment utilizes electrical forces to influence the energy fields within and surrounding my body.
As an inducement to allow me to use the Energetic Fitness System equipment, I hold harmless: Energetic Fitness Systems of Bellingham WA and their representatives, from "any and all consequences", either known or unknown, of whatever nature or kind.
I am aware that the Energetic Fitness Systems equipment is an experimental instrument and not intended nor represented to be a medical device for the diagnosis or treatment of any physical ailment or disease, nor is it a substitute for proper medical care administered by a licensed physician.
I am aware and I have had it explained to me and I understand the potential issues with taking pharmaceuticals within two hours prior to, and within two hours after, an EFS Charging Session.
I am aware and have had it explained to me and I understand the potential issues with taking pharmaceuticals or the consumption alcohol within two hours prior to, and within two hours after, an EFS Charging Session.
My Name Is:
My Full Name
My Age Is:
Adult, over 18 years
Minor, under 18 years
Street Address Line 2
State / Province
Postal / Zip Code
Signature of First Time User or Guardian's:
Should be Empty: