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Floatation therapy provides a deep state of relaxation that stimulates blood flow through all of the body's tissues, reduces stress hormone levels and releases natural endorphins. To ensure a comfortable clean and safe floatation experiance, I agree to the following (please intial below if you agree to the following statements):

 

I agree to the following:

  • All float tanks are in wet areas and I will take extra percautions for my own safety. I assume any and all liability due to injury and/or damage resulting from any slip and fall incident. 
  • If this is my first time floating, or if I require  refresher orientation, I will arrive 15 minutes prior to my appointment time. Otherwise, I will arrive 10 minutes prior to my scheduled float session.
  • I will turn off all my electronic devices before entering the float center corridor.
  • I agree to shower with soap and shampoo thoroughly before each of my float sessions to completly remove all dirt and oils from my body.
  • I am aware that keratin hair treatments can be affected by any salt water, epecially the high saline water in a float tank.
  • I agree that any cologne, perfume, makeup or creams will be fully removes from my body prior to entering the float tanks.
  • I agree that, if I smoke, I will refrain from doing so for at least 45 minutes prior to entering the float center to avoid bringing the odor of smoke into the tank.
  • If pregnant, I have consulted with, and secured written permission from my physician to use the floation tank.
  • I do not have any communicable or infectious disease, illness, or skin disorders. 
  • I do not suffer from uncontrolled seizures, epilepsy or incontinence.
  • I am physically capable of getting in and out of the float tanks on my own. If unable, I agee that I will have a certified aide to help me in and out of my session. 
  • I do not have a conditio nor am I on any medication which may have adverse effects due to immersion in the concentrated madnesium sulfate (Epsom salt) water solution.
  • I understand that foalting may lower my blood pressure and I will take extra care standing up after my float. If I have a history of high (> = 180/120) or low (< = 90/50) blood pressure, I have medical authorization to float. 
  • I understand that if I suffer from vertigo when lying down, the same could occur during a float session.
  • If I am diabetic with insulin dependency, I have medical authorizatoin to float. 
  • I am not under the influence of any medication, drug or alcohol. 
First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Do you have any serious medical condition or allergies? *

I understand that the floatation tanks use:

** Pharmaceutical grade Epsom salts

**Ultraviolet and Ozone sanitation systems

**Natural enzymes and non-toxic biodegradable cleaning products

**Hydrogen peroxide 

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with he safe and appropriate use of the tank. I agree to take full responsibility for my thoughts and actions while in the floatation tank and the waiver of liability and all agreements made herein shall apply to each and every use of the floatation tank.  

I hereby agree to irrevocable release and waive any claims thatI have now or may have hereafter again Cryotherapy of the Pines and its employees and agents. I will not hold the owner/operator of Cryotherapy of the Pines nor its employees and/or agents liable for any injury during a session or while on the premises. I have read and fully understand and agree to the above terms of this liability waiver agreement. I am signing this agreement voluntarily and recognize that my signature serves as a complete and unconditional release of all liability to the greatest extent allowed by law in the State of North Carolina. 

By signing below you agree that you have read it in its entirety and fully understand the Cryotherapy of the Pines flotation waiver and release form.

Parent or Guardian's Signature*
Electronic Signature Consent*
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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