I, First Name* Last Name* , agree to fully and forever release and discharge, and defend, indemnify, and hold harmless, the practitioner and/or practitioner’s company, Amanda Nelson/Fluid Motion, and its owners, directors, officers, representatives, members, employees, or agents, and MagnaWave, and its owners, shareholders, directors, officers, representatives, employees, or agents, from any and all injuries (including death), losses, damages, claims (including negligence claims), demands, lawsuits, expenses, and any other liability of any kind, of or to me, my property or any other person, directly or indirectly arising out of or in connection with the PEMF/Massage services provided by practitioner and/or practitioner’s company.
I, Amanda Nelson have permission to use MagnaWave on Animal's Name* on behalf of (animal’s owner) First Name Last Name .