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CRYOFIX WELLNESS WAIVER OF LIABILITY, ASSUMPTION OF RISKS, INDEMNITY AGREEMENT AND CONSENT FORM

Therapies covered by this Waiver & Release include but are not limited to the following therapies: Whole Body Cyrotherapy, Infrared Sauna, NormaTec Compression, Localized Cryotherapy, Cryo Facials, Theragun Therapy, Assisted Stretching, Cupping Therapy, Active Release Technique (ART), Scraping, Massage Therapy, and Cryoskin Slimming/Toning/Facial Services (collectively referred to as "Therapies").  While Therapies are used for various reasons, there are no guarantees. Therapies are not guaranteed to treat or cure any diseases, illnesses, injuries or the like. It is recommended that you consult with your physician prior to use of any of the Therapies. By signing this waiver you assume any and all associated risks and waive your right to sue.

CRYOTHERAPY

Whole Body Cryotherapy:

Whole body cyotherapy is the exposure of a person's skin to temperatures of - 238 to -274 degrees Fahrenheit for a short time (3 minutes or less). At this extreme temperature, the body activates several mechanisms that may have significant long-term health and cosmetic benefits including but not limited to caloric burning, weight loss, detox, relieve muscle soreness and pain, rejuvenate mind and body.

Safety Instructions for Whole Body Cryotherapy:

Refrain from use of lotions/oils on skin as the cryotherapy can cause frostbite (swelling, blistering of the skin, burning sensation, etc.)
Wool socks and gloves will be provided for you to wear during your session.
Men MUST wear underwear or shorts during a session.
For women, clothing is optional. If wearing clothing, you must refrain from wearing anything with a metal clasp or buckle.
Treatments are limited to 3 minutes per session. Overexposure to the cold temperatures may also cause frostbite.
During treatment, you must avoid inhaling the nitrogen fumes; while non-toxic, they are devoid of oxygen and may cause fainting.
You may end the procedure at any time if you experience any problems or anxiety.
Abnormal skin sensitivity to cold may be caused by certain foods, cosmetics, or medication, including but not limited to the following: Tranquilizers, High blood pressure medication.
A person who is less than (18) years of age may not use whole body cryotherapy without parental consent.

Localized Cryotherapy

Localized Cryotherapy is targeted to a specific muscle area or spasm can be applied via a localized device for 2-3 minutes depending on the area. Localized cold air treatments reach -25° to -40° F, and drop skin temperature rapidly without discomfort as our technicians are trained to measure skin temperature, watch the treated area for coloration changes, and interact with the customer to ensure comfort during treatments. This has been demonstrated to produce beneficial results compared to fifteen-to-twenty minute icing as this treatment flushes the tissue of fluid and waste rapidly (reducing inflammation and improving range of motion), causing a massive return of regenerative blood supply as the rewarming occurs quickly after application.

Unlike the whole-body chamber which is more systemic, our localized cryotherapy devices deliver a targeted cooling to specific areas of the body undergoing application. An example of localized treatment would occur with a low back, neck, hamstring, ankle, knee, wrist, or elbow pain. We recommend Whole Body Chamber (systemic) followed by localized cold air (targeted) after a short rewarming period for the best results.

Please refer to the safety instructions as set forth above.

Contraindications to using Cryotherapy: (You must initial this section)

Pregnancy, severe hypertension (BP> 170/100), untreated hypertension, heart attack in the last 6
months, acute or recent myocardial infarction, unstable angina pectoris, arrhythmia, symptomatic cardiovascular disease, cardiac pacemaker, congestive heart failure, unstable angina pectoris, pacemaker. peripheral arterial occlusive disease, deep vein thrombosis (DVT) or known Circulatory Dysfunction, Severe Anemia, Cold Allergenic Phenomenon (known allergy to cold
contactants), Bacterial and Viral Infections of the Skin, Wound healing disorders (open sores or discharging wound/skin conditions), Polyneuropathies, Raynaud’s Disease, Pregnancy, Vasculitis, Chilblains, Cold Urticarial (Cold allergy), peripheral arterial occlusive disease, decompensating diseases (edema) of the Cardiovascular & Respiratory System (COPD), venous thrombosis, acute or recent cerebrovascular accident, uncontrolled seizures, Raynaud's Syndrome, fever, tumor disease, symptomatic lung disorders, bleeding disorders, severe anemia, infection, claustrophobia, cold allergy, age less than 12 years (parental consent to treatment needed for anyone under 18 years old), acute kidney, urinary tract diseases, and bodyweight over 300 lbs.

Localized Therapy:
DO NOT use if you have Raynaud's Disease, Local Limb ischemia, Cold Allergy, Open/Uncovered wounds or sores, Paroxysmal cold hemoglobinuria, No abdomen area can be treated if pregnant.

CyroFacials:
DO NOT use if you have Raynaud's Disease, Botox in the last 48 hours, Dermal fillers in the past six weeks, Cold allergy, or open wounds.

NORMATEC RECOVERY BOOTS

The NormaTec PULSE Recovery System is best pneumatic compression system on the market for passive recovery. It does all the work while you relax in our anti-gravity chairs after your workouts.

Studies have shown that 20 minutes of rest in the NormaTec boots is equivalent to performing active recovery workouts in reducing delayed onset muscle soreness (DOMS) and in improving performance in subsequent workout sessions. It has multiple settings you can use depending on your individual preference and workout intensities. It is a 20 minute post workout massage without the cost, oils, and appointments.

Possible associated risks may include but are not limited to: cut off of circulation due to pressure, contusion/bruising. Other extreme causes include but are not limited to the risks identified in the Cyrotherapy. Assumption of Risks described above and herein including but not limited to blood clots, heart attack, stroke, and/or death. 

DO NOT use if: Acute deep vein thrombosis, Severe atherosclerosis or other ischemic vascular diseases, Severe congestive cardia failure, Existing pulmonary edema, Existing pulmonary embolism, Extreme deformity of the limbs, Malignancy in the legs, Untreated limb, infections/cellulitis, Limb fractures, Presence of Lymphangiosarcoma.

THERAGUN THERAPY:
The TheraGun is a lightweight, battery operated, muscle treatment device that increases blood flow, decreases lactic acid and interrupts the pain cycle. All of this helps the body's ability to recover after a workout, an injury or muscle pain from everyday life.

DO NOT use if have any of the above conditions. Potential risk include but are not limited to pain, discomfort, bruising.

ASSISTED STRETCHING:
DO NOT use if have any of the above conditions. Potential risk include but are not limited to pain, discomfort, bruising, overstretching, pulled/torn ligaments, muscles.

CUPPING THERAPY:
Cupping therapy is an ancient form of alternative medicine in which a therapist puts special cups on your skin for a few minutes to create suction. People get it for many purposes, including to help with pain, inflammation, blood flow, relaxation and well-being, and as a type of deep-tissue massage.

DO NOT use if have any of the above conditions. Potential risks include but are not limited to pain, discomfort, bleeding, bruising, redness, pierced/torn skin, skin infection, headache.

ACTIVE RELEASE TECHNIQUES (ART):
ART is a specific treatment method for soft tissue injuries, nerve entrapment, and decreased/limited range of motion and flexibility.
DO NOT use if have any of the above conditions. Potential risks include but are not limited to pain, discomfort, bleeding, bruising, redness, pierced/torn skin, skin infection.

GRASTON TECHNIQUE:
Graston Technique (GT) is an instrument assisted variation of traditional cross fiber or transverse friction massage.  The GT instruments consist of six stainless steel tools of various sizes and contours.  GT is a form of treatment used to “break up” or “soften” scar tissue, thus allowing for the return of normal function in the area being treated.
DO NOT use if have any of the above conditions. Potential risks include but are not limited to Local discomfort during the treatment, Reddening of the skin, Superficial tissue bruising, Post treatment soreness.

MOBILITY CORNER:
DO NOT use if have any of the above conditions. Potential risks include but are not limited to pain/discomfort, over stretching/pulling of muscles/ligaments, discomfort during the treatment, reddening of the skin, bruising, post treatment soreness.

Initial below to indicate that you have read through these contraindications carefully.

ASSUMPTION OF RISKS. I understand that there are potential risks and dangers which may arise in my use and participation in the Therapies. Fluctuations in blood pressure (due to peripheral vasoconstriction, blood pressure may briefly increase by up to 10 points systolically during treatment. This effect should reverse after the end of the procedure, as peripheral circulation returns to normal), Allergic reaction to extreme cold (rare), claustrophobia, anxiety, activation of some viral conditions (cold sores) etc. due to stimulation of the immune system. Other risks may include but are not limited to skin damage, nerve damage, frostbite, wrist, ankle, shoulder, back injury, hand amputation, foot amputation, loss of limbs, complex regional pain syndrome, reflex sympathetic dystrophy. I understand that these injuries and losses might result not only from my actions, but also from the actions, inaction, or negligence of others. I understand and appreciate these and all other risks in the use of cryotherapy. Despite the potential risks and damages associated with the use of Therapies, I voluntarily wish to proceed and I voluntarily and freely accept and expressly assume all risks and damages whatever they may be from the use of Therapies that could result in personal injuries, illnesses, disabilities, death and property damages to me. I have NOT had previous injuries as listed above. I KNOWINGLY AND VOLUNTARILY ASSUME ALL SUCH RISKS, ALL KNOWN AND UNKNOWN, EVEN IF ARISING FROM THE NEGLIGENCE OF RELEASEES, and assume full responsibility for my participation in the use of the Equipment.

RELEASE AND WAIVER OF LIABILITY

1. In consideration for using the Therapies, I, on behalf of myself, my personal representatives, heirs, executors, administrators, agents and assigns, HEREBY RELEASE,WAIVE, DISCHARGE, COVENANT NOT TO SUE, AND HOLD HARMLESS CRYOFIX WELLNESS, its officers, servants, agents, employees, contractors and volunteers (hereinafter referred to as RELEASEES) from any and all liability, including any and all claims, demands, actions, causes of action (known or unknown), suits, or judgments of any and every kind (including attorneys' fees), arising from any injury, property damage or death that I may suffer as a result of my participation in the Therapies, REGARDLESS OF WHETHER THE INJURY, DAMAGE, OR DEATH IS CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

2. I hereby confirm that no warranty or guarantee, or other assurance, has been made to me covering the results of the Therapies, and I hereby relieve them and hold them harmless from all liabilities for injury or damage that may occur to me. I fully understand the administration of the process, including possible adverse reactions, side effects, or other possible complications. It is understood that this CONSENT is being given in advance of any administration of the process, and is being given by me voluntarily to use the Therapies.

3. I am fully aware of the risks and hazards connected with the use of the Therapies, including the risk of physical injury, disability and/or death as the result of the use of Therapies, and I am voluntarily participating in said Therapies, and entering the above named premise to engage in such usage. I KNOWINGLY VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY/ILLNESS/DISABILITY/DEATH that may be sustained, or any loss or damage to property as a result of being engaged in such an activity.

4. I, on behalf of myself, my personal representatives, heirs, executors, administrators, agents and assigns, further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from and any and all losses, damages, claims, actions, suits, procedures, costs, damages and liabilities, including attorney's fees and costs, which occur as a direct or indirect result of my involvement in the use of the Equipment, and agree to reimburse the RELEASESS for any and all such expenses.

5.It is my express intent that this Release and Hold Harmless Agreement shall bind the members of my family and spouse (if any), if I am alive, and my heirs, assignees and personal representative, if I am not alive, and shall be deemed as a RELEASE, WAIVER, AND DISCHARGE of the above named RELEASEES. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of California.

6. I agree that this Agreement is intended to be as broad and inclusive as is permitted by law and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.

7. I understand that Therapies is intended and provided for various purposes such the basic purpose of calorie burning, weight loss, relaxation, stress reduction, relief of muscular tension, recovery from muscular tension, and recovery from surgery, illness or injury. I further understand that there are no guarantees the Therapies will accomplish any such purpose. Further, I understand that Therapies should not be construed as a substitute for medical examination, diagnosis, or treatment and that I should see a physician, chiropractor, or other qualified medical specialist for any mental or physical ailment prior to using the Therapies.

8. I understand that the therapists of the Therapies are not medical professionals and therefore not qualified to perform skeletal adjustments, diagnose and/or prescribe, and that nothing said in the course of the session should be construed as such.

9. Because Therapies are contraindicated under certain conditions, I affirm that I have stated all my known medical conditions and answered all questions honestly. I agree to keep the therapists updated as to any changes in my medical profile and understand that there shall be no liability on the therapist's part should I forget to do so.

My signature below constitutes my acknowledgment that (1) I have read, understand, and fully agree to the foregoing CONSENT, (2) the proposed use of the Therapies has been satisfactorily explained to me and I have all of the information I desire and (3) I hereby give my authorization and consent. This CONSENT shall stand as long as I use the Therapies at the location now and in the future.

I have read the instructions for proper use of the facilities and do so at my own risk and hereby release the owners, operators, franchisers, or manufacturers, from any damage or harm that I might incur due to use of the facilities.

IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT:

I have read and understand the foregoing Waiver of Liability and Hold Harmless Agreement.
I understand that CryoFit Wellness in its sole discretion can refuse service to me for any reason including my own personal safety or the safety of itself or any of its employees.
I am at least eighteen (18) years of age and fully competent.
I have given up considerable future legal rights.
I certify that I do NOT suffer from any of the contraindications listed above.
And I execute this Release freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me.

Furthermore, I agree that I will comply with all instructions on the use of the Therapies and that I am using these services at my own risk. I agree to use the Therapies within the terms of the contract dates and understand that refunds are not given on unused portions of purchased packages.

Photographs

I agree to the use of my name, age, likeness, photographs, school/occupation/affiliation, testimonials, reasons for use of therapy including but not limited to for medical conditions and other related items without compensation, unless I, in writing, separate and apart from this Agreement, expressly provide written declination to non-use otherwise.

 

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Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
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By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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