Customer History/Waiver

Customer History/Waiver

Customer health history and liability waiver Form Preview
Customer History/Waiver
  • Norspring/eCryotherapy of North America, LLC.

    WAIVER AND RELEASE OF LIABILITY
  • What is Whole Body Cryotherapy?

    Cryotherapy is the process of cooling the body through rapid extreme cold air in order to obtain various health benefits. The process causes a fight or flight response in the body. The blood is supercharged with anti-inflammatory proteins, muscular enzymes, and higher levels of oxygen resulting in a very effective treatment for recovery, relief, and overall wellness.

    Safety Instruction for Cryotherapy:

    • Your skin must be dry before beginning the cryotherapy sesson
    • Dry socks, headband, mittens, mask and provided footwear must be worn during your whole body cryotherapy session to ensure a safe experience.
    • All jewelry must be removed. Any piercings that cannot be removed must be covered by tape provided by Norspring.
    • Once in chamber, do not touch the chamber walls.
    • Maintain eye contact with teh Norspring tech through the large window and follow the tech's instructions.
    • You may stop the session at any time for any reason.
    • Parental consent is required for any person under eighteen (18) years of age to participate in whole body cryotherapy.

    Possible Risks of Whole Body Cryotherapy:

    It is possible that participating in whole body cryotherapy may result in various complications, which may include, but not be limited to, the following: blood pressure fluctuations, allergic reactions to extreme cold, claustrophobia, anxiety, hyperventilation, and skin irritation.

    Other Services:

    Norspring provides not only whole body cryotherapy, but also cryotherapy for specific areas of the body and cryofacials.

    THIS WAIVER AND RELEASE OF LIABILITY APPLIES TO ALL SERVICES PROVIDED BY NORSPRING.

  • WAIVER AND RELEASE OF LIABILITY


    For and in consideration of being allowed to participate in the cryotherapy services, including but not limited to whole body cryotherapy, cryotherapy provided to a limited area of the body, cryofacials, and any other services (the “Activity”) provided by NORSPRING and/or eCryotherapy of North America, LLC, and its respective affiliates, managers, employees, members, agents, attorneys, staff, volunteers, representatives, predecessors, successors and assigns (collectively, “NORSPRING”) on its property or on any other property or location the Activity may be conducted, I hereby voluntarily release, discharge, waive and relinquish any and all claims or actions to the fullest extent possible by Tennessee law, including but not limited to any claims or actions for negligence and any other damages for personal injury, death or other damages, which may hereafter accrue to me as a result of my participation in the Activity. I hereby release and forever discharge NORSPRING for any physical or psychological injury, including, but no limited to illness, paralysis, economic or emotional loss, or other damages I may suffer as a result of my participation in the Activity, including traveling from an Activity related event.

    I hereby irrevocably and unconditionally agree for myself, my personal representatives, my heirs, next-of-kin, insurers, successors, and assigns, as follows:

    1. ASSUMPTION OF RISK. My choice to participate in the Activity and to travel upon completion of and after any Activity related event is knowing, voluntary, and made for my personal enjoyment. I understand that participation in the Activity and the travel upon completion of and after the Activity involves inherent risks and dangers of accidents, rescue operations, emergency treatment, property loss or damage, serious personal and bodily injury, emotional trauma, death, and severe personal and economic losses. These may result not only from my own actions, inactions, or negligence, but also from the actions, inactions, or negligence of others, or the condition of the facilities or equipment. Further, there may be other risks not known to me or reasonably foreseeable at this time. I understand and I have considered the risks involved, and I voluntarily and freely choose to assume these risks.

    2. RELEASE FROM LIABILITY. I FULLY AND FOREVER RELEASE AND DISCHARGE NORSPRING 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 MY PARTICIPATION IN THE ACTIVITY OR TRAVEL FROM THE ACTIVITY, EVEN IF IT IS DUE TO THE NEGLIGENCE, INJUDICIOUS ACT, OMISSION, OR OTHER FAULT OF NORSPRING.

    3. INDEMNITY. I will defend, indemnify, hold harmless and reimburse NORSPRING from and for all damages, losses, costs, or expenses (including legal fees) incurred by NORSPRING or paid by them to any person (including me or my insurers) in respect of any accident, injury (including death), loss, or property damage, however caused resulting from, arising out of, or otherwise in connection with my participation in the Activity. I will reimburse NORSPRING if anyone makes a claim against NORSPRING in connection with my participation in the Activity, including, without limitation, any accident I may be involved in or any injury, loss, damage to me, other parties or property however caused.

    4. COVENANT NOT TO SUE. I will not initiate any claim, lawsuit, court action, or other legal proceeding or demand against NORSPRING, nor join or assist in the prosecution of any claim for money or other damages which anyone may have, on account of injuries (including death), losses, or damages sustained by me, other parties, or my (or others') property in connection with my participation in the Activity, and I waive any right I may have to do so. This means that I cannot sue to hold NORSPRING responsible for any injury, loss, or damage sustained by me, other parties, or my (or others') property in connection with the Activity, even if it is due to the negligence, injudicious act, omission, or other fault of NORSPRING.

    5. MEDICAL EXPENSES. I hereby consent to receive medical treatment which may be deemed necessary in the event of any illness, accident or injury, or medical emergency resulting from or in connection with my participation in the Activity and understand that I am solely responsible for all costs related to such medical treatment, medical transportation and/or evacuation.

    6. REPRESENTATIONS. I am over eighteen (18) years of age. I am in good health, in proper physical condition, and I do not have any medical or other conditions that would impair my ability to participate in the activity. If at any time I believe conditions to be unsafe or that I am no longer in proper physical condition to participate in the Activity, I will immediately discontinue further participation in the Activity.

    7. COVENANTS. I will follow any and all instructions, recommendations, and cautions of NORSPRING at all times during the Activity, in respect of my participation in the Activity.

    8. SEVERABILITY. In the event that any provision contained within this Release and Waiver of Liability shall be deemed unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the severed clause does not affect the intent of the parties.

    BY SIGNING, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD ALL OF THE TERMS OF THE COVENANTS AND AGREEMENTS AND THAT I AM VOLUNTARILY GIVING UP SUBSTANTIAL LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE NORSPRING. I FURTHER ACKNOWLEDGE THAT ALL INFORMATION PROVIDED BY ME HEREIN IS TRUE AND CORRECT, IS MATERIAL TO THIS AGREEMENT, AND HAS BEEN RELIED UPON BY NORSPRING IN DECIDING TO ALLOW MY PARTICIPATION IN THE ACTIVITY.

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