PLEASE READ BEFORE SIGNING
1. I understand and voluntarily accept the risks associated with the use of Revive Wellness’ facilities. I agree Revive Wellness will not be liable for death or any injury, including, without limitation, personal, bodily or mental injury, economic loss or damage to me resulting from negligence, other acts by anyone acting on Revive Wellness’s behalf, or anyone using the services of the facilities of Revive Wellness, to the fullest extent permitted by law. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, and assume full responsibility for my participation. I understand some risks cannot be known in advance.
2. I and/or any of my heirs, assigns, personal representatives, or next of kin hereby release Revive Wellness from all claims or liabilities for death, personal injury or property loss or damages of any kind sustained while on the premises and/or from any advice or services provided by an employee, independent contractor or any representative of Revive Wellness. I agree that this release is in effect for all sessions or any other services, and will not expire unless specifically requested by either party.
3. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, will DEFEND, INDEMNIFY and HOLD HARMLESS Revive Wellness, its owners, officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity (“Releasees”), with respect to any and all injury, disability, death, or loss or damage to person or property, whether arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law.
4. I understand that the staff does not diagnose illness or prescribe medical treatments or pharmaceuticals and that services rendered by the staff are not medical in nature and are not a substitute for diagnosis and treatment by a licensed medical professional. I understand that specific results cannot be guaranteed.
5. If I observe a hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the Revive Wellness staff immediately. If I suffer an injury or experience pain during my use of Revive Wellness equipment, I will immediately cease using the equipment and notify a staff member.
6. If I have a medical condition that might be affected by use of Revive Wellness’ equipment, I will first seek the advice of my doctor before using the equipment.
7. The following release applies to whole-body cryotherapy:
a. Participation in a whole-body cryotherapy session involves exposure to extreme cold temperature for a short period of time. I understand that I must keep my head outside the booth at all times during the treatment. I understand I can exit the chamber at any time. b. I understand that a staff member may ask me about my medical status prior to a cryotherapy session. I agree to answer those questions fully and honestly. WHO SHOULD NOT USE CRYOTHERAPY: Includes but are not limited to: Pregnant women, children, people with high blood pressure, heart conditions, blood circulation problems, uncontrolled asthma, or health conditions like cold urticaria, peripheral neuropathy, pacemaker, history of stroke, high risk of infection, unstable angina pectoris, arrhythmia, peripheral arterial occlusive disease, venous thrombosis, acute or recent cerebrovascular accident, uncontrolled seizures, Raynaud’s Syndrome, fever, tumor disease, symptomatic lung disorders, bleeding disorders, severe anemia, infection, acute kidney and urinary tract diseases, and people with previous adverse reactions to cryotherapy. WHO SHOULD NOT USE LOCAL CRYOTHERAPY: Includes but not limited to: People with Undiagnosed skin lesions, melanoma, active or severe eczema, rashes, or dermatitis, People with Raynaud's disease, cold urticaria, progressive diseases like MS, ALS, Parkinson's, or neuropathy, circulatory disorders, wound healing disorders, metal implants, People who are Pregnant, People with uncontrolled hypertension, severe allergy to cold, active infection, open breaks or cuts in the skin, and people with previous adverse reactions to cryotherapy
c. I understand it is mandatory to wear gloves, and enclosed slipper booties during my whole-body cryotherapy session as a safety precaution. I also understand that I should not remove personal protective equipment at any time during my whole-body cryotherapy session.
d. I understand that wet or damp clothing cannot be worn at any time during a whole body cryotherapy session.
e. I am not pregnant, a professional athlete, or wearing a pacemaker.
f. I agree that I shall not engage in cryotherapy more than 2-3 times per week.
8. The following release applies to all light therapy: I understand it is mandatory to wear eye protection during a light therapy session. I also understand that I should not remove the eye protection at any time during my light therapy session.
9. The following release applies to sauna:
a. Participation in a sauna session involves exposure to extreme heat and high temperatures for a period of time. I can exit the sauna at any time.
b. I understand that I should exit the sauna immediately if uncomfortable, dizzy or sleepy.
c. I understand staying in the sauna too long can cause overheating.
d. I understand that a staff member may ask me about my medical status prior to a sauna. I agree to answer those questions fully and honestly. WHO SHOULD NOT USE SAUNA: Includes but are not limited to: Pregnant women, Children and people with heart disease, uncontrolled high blood pressure, People taking medications that interfere with the body's ability to regulate temperature, or medications which make you drowsy, People with kidney disease, open wounds, seizure disorders, chronic respiratory disease, atopic dermatitis, People under the influence of alcohol or drugs: Alcohol consumption around the time of sauna use may increase the risk of sudden death. DO NOT eat a large meal prior to entering the sauna. DO drink water before and after your sauna session.
10.Participation in the Hydromassage Bed involves jets of pressurized water to massage specific areas of your body. The water is contained within the bed, so it's a dry massage. You can control the water pressure, speed, and which areas of your body are targeted using a touch-screen interface..WHO SHOULD NOT USE HYDROMASSAGE BED: Includes but not limited to: People Bleeding disorders, broken capillaries, or other conditions that compromise blood vessels, People with High blood pressure, people who are Pregnant, People with Acute injuries such as fractures, or open wounds, people with Infections, any infectious communicable or contagious diseases, People with neurological disorders, heart conditions, thrombosis, or spinal conditions, Skin problems such as rashes, eczema and severe acne, Any acute (sudden, severe onset) inflammatory response-symptoms include fever, heat, loss of function, redness and swelling, unstable cardiac or neurological conditions, acute second or third degree burns, Thrombosis, the presence of blood clots or clotting conditions, Degenerating disc diseases or injuries (i.e. ruptured, bulging and herniated discs). Manufacturers recommend limiting your hydromassage to 15 minutes per session.
11. Participation in leg compression involves plastic sleeves that inflate with air and squeeze the legs from the bottom to the top. WHO SHOULD NOT USE LEG COMPRESSION: Includes but not limited to: People with leg ulcers, burns, dermatitis, or skin infections, People with Peripheral vascular disease: This includes severe peripheral arterial occlusive disease (PAOD), Edema: Such as edema due to congestive heart failure, Active phlebitis: Or deep vein thrombosis (DVT), Localized wound infection or cellulitis: This includes erysipelas, Conditions that affect your ability to feel: Such as peripheral neuropathy.
12. WHO SHOULD NOT USE ZERO GRAVITY MASSAGE CHAIRS WITH COMPRESSION: Includes but not limited to: People with leg ulcers, burns, bone injuries, blood clotting, dermatitis, or skin infections, People with Peripheral vascular disease: This includes severe peripheral arterial occlusive disease (PAOD), Edema: Such as edema due to congestive heart failure, Active phlebitis: Or deep vein thrombosis (DVT), Localized wound infection or cellulitis: This includes erysipelas, Conditions that affect your ability to feel: Such as peripheral neuropathy.
13. WHO SHOULD NOT USE LIGHT THERAPY: Includes but not limited to: People taking Photosensitizing medications (medications that increase sensitivity to sunlight, such as isotretinoin (Accutane), lithium, melatonin, phenothiazine antipsychotics, and some antibiotics ), People with a history of skin cancer or systemic lupus erythematosus, people with diseases that affect the retina of the eye, such as diabetes, glaucoma, or cataracts, should consult an eye specialist before using light therapy, people who are pregnant, Epilepsy, Botox or cosmetic fillers - You should wait at least five days after getting Botox or cosmetic fillers before using light therapy.
14. PEMF therapy involves applying electromagnetic pulses to targeted areas of living tissue over a short duration of time. The therapy is thought to work by inducing electrical changes in cells, which can help stimulate cellular repair, decrease inflammation, and relieve pain. WHO SHOULD NOT USE PEMF: Includes but not limited to: People who are pregnant, people with implanted electrical devices such as cardiac pacemakers, cardiac stents, medicine pumps such as insulin pumps, aneurysm clips, or coils, implanted stimulators such as deep brain stimulators or vagus nerve stimulators, cochlear implants in the ear, bullet fragments, or any magnetic implants or metal devices or objects in the body.
15. A grounding mat, also known as an earthing mat, creates an electrical connection between your body and the Earth to simulate walking barefoot on the ground. WHO SHOULD NOT USE GROUNDING MAT: Includes but not limited to: People who are pregnant, people with compromised immune systems, People taking blood thinners, like Coumadin, People with existing nerve damage, People with open wounds, severe diabetic neuropathy (nerve damage in the feet), poor circulation in the feet, active infections on the feet, extreme sensitivity to temperature changes, or any condition that significantly impacts your ability to feel sensations, People taking medication to thin the blood, regulate blood sugar, control blood pressure or regulate hormone levels.
16. Halotherapy, also known as salt therapy, is an alternative treatment that involves breathing in salt particles generated from a halogenerator that grinds salt into tiny particles and disperses them into the air in a salt cave, providing a safe and effective form of dry salt therapy, also known as halotherapy. WHO SHOULD NOT USE HALOTHERAPY: Includes but not limited to: People with certain health conditions should not try salt therapy, also known as halotherapy, or should consult with a doctor before doing so: People with Serious health conditions: such as cancer, heart problems, or tuberculosis, should seek medical advice before trying salt therapy. People with active respiratory infections, contagious diseases, or infections associated with a fever should avoid salt therapy. Skin conditions: People with open wounds or skin infections. Pregnant women. People with severe or uncontrolled hypertension should avoid salt therapy. People on active chemotherapy should avoid salt therapy.
17. I will consult a doctor before using any services or treatments if I have any health concerns or conditions that could be adversely affected.
18, I agree not to use any treatments if I am under the influence alcohol or any illegal substances.
19. This release together with Revive Wellness’s rules and regulations cannot be amended, except in writing by both parties.
20. This release is governed exclusively by the laws of the Commonwealth of Massachusetts and its venue is in Essex County, Massachusetts.
21. Photo release: I hereby acknowledge that my photo may be taken, edited, and changed, to be used for promotional materials. I hereby acknowledge that I will not be entitled to payment or any sort of charge for such action. I authorize the use of my photograph for, but not limited to, publication on the internet, magazines, journals, books, articles, etc., provided that it is done for lawful purposes. Upon the usage of my photographs, I consent to such materials becoming the sole property of Revive Wellness, LLC and that I will no longer be entitled to them, provided that it is done for lawful purposes. I hereby release all rights to any, but not limited to, claims, rights, demands, and/or any causes of action by me or my representatives, heirs or anyone else. Furthermore, I hereby waive my right to any royalty or any other compensation with regard to the usage of the photos referred to in this Form.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.