Loading...

Float Therapy: Assumption of Risk, Waiver and Release from Liability


At Salt Wellness Centre, we make all reasonable efforts to ensure a comfortable, clean and safe environment for you. As such, you may be provided the opportunity to float.

So that you have a comfortable and safe experience, please read the following and sign your name to indicate your agreement.

This waiver applies to the now contemplated float and all subsequent float experiences taken by the undersigned with Salt. 

1 . I will NOT use the floatation tank or room 
(a) With oils or creams on my body; 
(b) If I have any communicable disease; 
(c) Under the influence of drugs or alcohol; 
(d) If I am epileptic unless in the opinion of my physician my epilepsy is under medical control so that I am in sufficient control of my seizures not to endanger myself in the floatation tank; 
(e) If I am pregnant, unless I have consulted and received permission from my physician; 
(g) If I suffer from diabetes, unless, in the opinion of my physician, my diabetes is under medical control so that I am in sufficient safety to use the floatation tank; 
(h) If I suffer or have suffered from chronic heart disease, unless, in the opinion of my physician, my chronic heart disease is under medical control so that I am in sufficient safety to use the floatation tank. 

2. I further understand that the floatation tank and room uses (1) Epsom salt (U.S.P. (pharmaceutical) grade magnesium sulfate, (2) Bromine (potassium monopersulfate or monopersulfate compound) and, (3) natural enzymes, botanical extracts and non-toxic biodegradable cleaning products which will be in the water and that some people may experience skin allergies or reactions to such chemicals. 

3. I also hereby agree and understand that I shall have consulted with my own physician prior to using the floatation tank or room if I am currently taking any medication or under a physician's care for any reason. 

4. I,  a  client  of  Salt Wellness Centre (Salt)  hereby  release  Salt  Wellness Centre (Salt)  and  its  directors,  officers,  employees,  agents  and  professional  staff  from  all  actions,  causes  of  action,  suits,  claims,  liability,  damages  and  demands  of  any  kind  ,  whether  direct,  indirect,  special,  exemplary  or  consequential,  including  interest  thereon  (the  Claims)  which  may  occur  as  a  result  of  any  injury  including  death  sustained  by  myself  or  others  resulting  from  the  receipt  of  float  therapy.    
5. I further agree to take full responsibility for my thoughts and actions while floating.  The waiver of liability and all agreements made herein shall apply to each use I make of the floatation tank or room. 

Requirements:

Customers are required to shower and shampoo before floating. (Rinse soap, body lotions & hair product off body thoroughly).

Floating is done in the nude. (No bathing suits required.)

Customers are required to use the washroom before floating. 

Customers with freshly dyed hair (within 48 hours) are not permitted to float.

Avoid waxing/shaving before floating to avoid salt/skin irritation. 

Avoid caffeine and heavy foods 1.5 hours prior to floating. 

If a guest contaminates the pool in any way they will be required to pay the cost of clean-up and refilling the tank or room with salt, in excess of $500.00 (If you pee in the floatation tank or room, the water turns purple and an alarm will sound). Seriously though, our water is filtered 4 times between floaters, it’s tested daily & we’re governed by Fraser Health Authority. 

Float Etiquette 
The float tank & float room is used for relaxation purposes and needs to remain a quiet, tranquil environment. Please make every effort to be respectful and not disturb other customers while floating. 
Late Policy 
If you are late for your float (past 5 minutes) and there is a float scheduled immediately after your appointment, your float will need to be rescheduled to avoid inconveniencing the next customer. No refund will be granted, thank you for your understanding. 
Safety Agreement 
While every effort is made to protect the health and safety of guests using the facilities, it is expressly agreed that use of facilities undertaken by me is at my own risk, and that Salt Wellness Centre (Salt) shall not be liable for any claims, damages, actions (or causes of actions) within the float premises. 
 

First Client Name

First Name*

Middle Name

Last Name*

Phone*
First Client Date of Birth*
First Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
First Client Signature*
Second Client Name

First Name*

Middle Name

Last Name*
Second Client Date of Birth*
Second Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Third Client Name

First Name*

Middle Name

Last Name*
Third Client Date of Birth*
Third Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Fourth Client Name

First Name*

Middle Name

Last Name*
Fourth Client Date of Birth*
Fourth Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Fifth Client Name

First Name*

Middle Name

Last Name*
Fifth Client Date of Birth*
Fifth Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Sixth Client Name

First Name*

Middle Name

Last Name*
Sixth Client Date of Birth*
Sixth Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Seventh Client Name

First Name*

Middle Name

Last Name*
Seventh Client Date of Birth*
Seventh Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Eighth Client Name

First Name*

Middle Name

Last Name*
Eighth Client Date of Birth*
Eighth Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Ninth Client Name

First Name*

Middle Name

Last Name*
Ninth Client Date of Birth*
Ninth Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Tenth Client Name

First Name*

Middle Name

Last Name*
Tenth Client Date of Birth*
Tenth Client Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
Client 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*
We send payment receipts by email to help minimize our footprint, save trees and stay green. By giving us your email address you are providing us with explicit permission to contact you via email. We will never share your email address and you can breakup with us (or unsubscribe) at any time. We’ll only email you about specials, fun events, and the occasional super entertaining newsletter. We promise not to bug you, or to send you photos of our cat, our kids or what we had for dinner. We like you & we hope you’ll stay in touch.
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 Float History
Have you Floated before?*
Yes
No
How did you hear about Salt? *
Driving by
Groupon
Internet
Newspaper
Other
Social Media
Through a friend
Why are you floating? (Choose all that apply)
Arthritis
Chronic Pain
Concussion
Enhancing Creativity
I heard Joe Rogan floats
I want to try it....
Injury Recovery
Mental Wellness
Other
Relaxation
Stress Relief
TO RECHARGE
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!