Liability Waiver
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Email
example@example.com
Phone Number
Please enter a valid phone number.
I agree with the following:
I understand that the massage service offered is for therapeutic purpose of general wellness, stress reduction, and relief of muscular tension.
Information about massage therapy, its potential benefits, effects, risks have been explained to me and I understand this information. I understand the risks include but are not limited to: Superficial bruising, Short term muscle soreness, Exacerbation of undiscovered injury
I, my heirs and my representatives will not hold the company, its employees, or its agents responsible in any way for the actions of Massago LLC
I am giving my consent to receive services by Massago LLC
Date
-
Month
-
Day
Year
Date
Signature
Submit
Submit
Should be Empty: