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I agree to the Terms & Conditions

DISCLAIMER: LLerinaByTanzzy is not responsible for lost or stolen property, nor will LLerinaByTanzzy be held liable for any injury or condition that arises from the application of massage despite completion of this form. This form is intended as an assessment tool only and serves as a guide for the application of massage, not for medical treatment or medical assessment. Draping will be used during this session. Only the body area being worked on will be uncovered. Clients under the age of 18 must have a parent or legal guardian present to provide a signature for authorization for the therapeutic massage session and must be with the same-gender massage therapist. Clients under the age of 17 must have a parent or legal guardian present to provide a signature for Create your own automated PDFs with JotForm PDF Editor1 authorization of this facial/massage session. It is my choice to receive spa treatments. I realize that the treatment is being given for the well-being of my body and mind. I agree to communicate with my service provider any time I feel as though my well-being is being compromised. I understand that the service providers do not diagnose illness, disease, or any physical or mental disorder, nor do they prescribe medical treatment, or pharmaceuticals. I acknowledge that spa services are not a substitute for medical examination or diagnosis and that it is recommended that I see a primary Health Care provider for that service. I have stated all medical conditions that I am aware of and will update the service provider of any changes in my health status. I understand that all employees of LLerinaByTanzzy are licensed professionals and that by law they have the right to refuse service on any client at any time if they feel as though their well-being is compromised. I understand and voluntarily accept the risks associated with the facial and/or any other services, including but not limited to Massage, Facials, Sauna, ZIFiT, ECT., or the use of any of the location’s facilities. Except where prohibited by law; I acknowledge and voluntarily assume the risk of injury, accident, or death that may arise from the use of Full Spectrum Infrared Sauna, or any other program, event or activity. I agree LLerinaByTanzzy 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 in LLerinaByTanzzy, anyone acting on LLerinaByTanzzy's behalf, or anyone using the services of the facilities of LLerinaByTanzzy, to the fullest extent permited by law. This agreement together with LLerinaByTanzzy wellness plan rules and regulations, constitute the entire agreement between you and us and cannot be amended, except in writing by both parties. Myself and/or any of my heirs, executors, representatives, or assignees hereby release LLerinaByTanzzy from all claims or liabilities for death, personal injury or propery loss or damages of any kind sustained while on the premises, during the use of the full spectrum Infrared Sauna and/or from any advice or services provided by an employee, independent contractor or any representative of LLerinaByTanzzy. I agree that this application and waiver is in effect for all massages, facials and/or Full Spectrum Infrared Sessions or any other services, and will not expire unless specifically requested by either party. I understand that LLerinaByTanzzy is a tranquil and professional environment and that any inappropriate behavior may result in temination of my services and full payment is expected. By signing this form, I agree to the above terms and release LLerinaByTanzzy and its employees from any liability. Client Signature:_____________________ Date:___________________ Therapist Signature:___________________ Date:_________________ FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION): This is to certify that I, as a parent/guardian with legal responsibility for this participant, do consent and agree to his/er release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabiity incidents to my minor child’s involvement or participation in these programs as provided above, to the fullest extent permitted by law. Parent/Guardian if Minor: ___________________________________  Date: ____________ Emergency Phone:_____________

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