I (name below) acknowledge that I am renting and voluntarily using a birth pool to labour and/or deliver a baby. The rental cost is included in my birth doula package. Only the La Bassine Pool, Air Pump and Sump Pump are included in the package. The disposable items must be purchased separately.
I AM AWARE OF THE RISKS OF USING, LABOURING, AND BIRTHING IN A BIRTH POOL. I AM VOLUNTARILY PARTICIPATING IN THESE ACTIVITIES WITH KNOWLEDGE OF THE DANGER AND/OR PROPERTY DAMAGE THAT MAY OCCUR AND I ACCEPT ALL RESPONSIBILITY OF OUTCOMES, WHETHER THOSE RISKS ARE KNOWN OR UNKNOWN.
I release The Maya's Nest Birth Services and all its employees from any and all actions, claims, or demands that I, my assignees, heirs, distributees, guardians, next of kin, spouse and legal representatives now have, or may have in the future, for injury, death, or property damage related to using the birth pool, fill hose, tap adapter, air pump and/or sump pump.
I agree to replace any part of the rental that I may damage or have used improperly (La Bassine Pool, Air Pump, Sump Pump) and this replacement will be by the discretion of The Maya's Nest Birth Services.