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Higher Elevation Healing Arts

Client Release Waiver for Float Sessions

I agree to take full responsibility for myself as I use the float room, shower, and all other rooms/amenities at
Higher Elevation Healing Arts facility. I accept that I am participating in float therapy offered in a floatation
room and I assume all risk unto myself. I declare myself physically and mentally capable to participate in float
therapy and the use of the floatation room. I will not misrepresent myself to any agents/staff of Higher
Elevation Healing Arts about my ability to operate all equipment while at Higher Elevation Healing Arts.

I Agree

I understand that I will receive a pre-float tour with verbal instructions during my initial visit
about the use and process of the float room. I understand that the pre-float instructions and this written waiver
are to serve as the primary source of information and education of the use of the float room, and the facility.
I Agree

I understand that proper use of the earplugs is essential for keeping salt from entering the ear canal. I understand
that the earplugs are not designed to be inserted into the ear canal and that they must be applied before
showering. As well, I understand that ear tubes are not compatible with floating.
I Agree

I understand that I am in control of this experience and can stop at any time. I take full responsibility for myself,
and my body while at Higher Elevation Healing Arts. I understand Higher Elevation Healing Arts is not a medical
facility and does not accept responsibility regarding professional medical advice or service.
I Agree

If I have a history of heart trouble, epilepsy, seizures or blackouts I have informed the staff of Higher Elevation
Healing Arts of this medical condition (for knowledge purposes only) and am aware that l will utilize the float
rooms by myself or with a partner for safety.
I Agree

Should I have an emergency situation while inside the float room I am aware that there is a two-way intercom
system that I can use to request assistance.
I Agree

I understand that I cannot float if I have dyed my hair within 7 days or if any color/dye remains on a white towel.
While it will not hurt my hair, the dye could discolor and contaminate the salt water, resulting in a $1,000 fee.
I Agree

Higher Elevation Healing Arts provides shampoo and body wash for the pre-float shower AND shampoo, conditioner and body wash for the post-float shower. Should I decide to bring my own personal shampoo, conditioner, or soap, I understand that it may not be used prior to my float session, only after the float session is complete for my post float shower. Higher Elevation Healing Arts also provides earplugs, make-up remover or wash cloth, vaseline, towels and a robe for your use. We recommend that you bring a brush, comb and/or any other personal items you desire.
I Agree

I agree to abide by the 5-minute mandatory shower using the provided wash cloth to exfoliate and remove natural oils, lotions, deodorants, hair products, etc. even if I showered prior to arriving to Higher Elevation Healing Arts. I will honor the 5-minute shower rule to avoid a $1,000 fine.
I Agree

I understand that floating is not appropriate if I have had any symptoms of contagious illness in the past 72 hours including but not limited to fever, cough, rash, diarrhea, vomiting or any other medical condition that could be contagious. If I have had any of these symptoms I will reschedule my float session.
I Agree

Higher Elevation Healing Arts takes the cleanliness and sanitation of our water so seriously that we have chosen to enforce a $1,000 fee for anything left in the float room water or as mentioned above, should a person skip the mandatory 5-minute shower. Please be advised that due to the density of the salt, it is very evident if anything is left behind. It is our belief that each of us should use the float facility with the utmost respect for the next client by honoring the water sanitation guidelines.
I Agree

I understand all bottles, crockery, glassware, and any other hazardous objects are prohibited in the float room area.
I Agree

I will abide by the 8-hour cancellation policy when rescheduling or canceling appointments. Otherwise, I understand that I will be charged the full session price, realizing that this appointment time was exclusively reserved for me.
I Agree

I declare that I am not under the influence of any substance, legal or otherwise, that would impair my judgment while using the float room at Higher Elevation Healing Arts.
I Agree

I agree not to exceed the session I have reserved and am aware that the pre-float shower is made up of 8-minutes, float time is a full 60, 75 or 90-minutes and the post shower and changing is 12-minutes. I understand I will need to vacate the room to give Higher Elevation Healing Arts the appropriate time needed to clean the float room for the following client. Should I not vacate the room in time I am aware that there will be an additional charge of $40.00 to my account.
I Agree

I agree to lock my private float suite while in use.
I Agree

I understand that at the end of my float session, the float room light will come on notifying me that my float session is over. At that point I will exit the floataround to begin my post float shower. If the staff does not hear the shower running they will attempt to communicate via the float room two-way intercom system. Should you not respond, please be aware that a staff member will knock on the outside door attempting to wake you. Only after 1) the float room light has come on, 2) the float room jets have come on, 3) we have utilized the intercom, and finally 4) knocked on the outside door will we enter the room to wake/inform you that your session is over. If we must enter the room we will enter with an objective to honor your privacy.
I Agree

I understand if I am experiencing seizures or have a history of seizures, I must have another trusted adult present during my float session should I require immediate attention.
I Agree

I acknowledge that I am voluntarily participating in this service and agree not to hold the facilities, operators or owners liable for any injury to self or loss of personal items.
I Agree


Pre and Post Float Instructions

Arrival pre-float
• Silence your phone (Its best to turn off completely)
• Use the restroom if needed
8 minutes pre-float
• Lock your door
• Insert earplugs based on instructions
• Remove make-up with remover cloths
• Apply petroleum jelly to open wounds
• If you are menstrating or expect to, please use a tampon or sanitary cup during your float.
• Shower using the body wash with washcloth & shampoo only
• Rinse body completely
• Enter the Floataround slowly with caution
• Inside the Floataround, use washcloth to dry face and hairline
For your convenience, the lights are motion activated and will automatically turn on and off.


Float
• Lay back & enjoy your float
• Enjoy music, lights or complete silence and darkness
• Remember there is no wrong way to float
• The lights will come on when it is time to exit the pool and you will hear a chime


12 minutes post-float
• Use hand rails to exit the Float Room slowly
• Rinse hair prior to removing earplugs (please store earplugs for subsequent visits)
• Use ear rinse (twice recommended, squeeze gently)
• Shower with body wash, shampoo & conditioner
• Dress in either the provided robe or your clothing
• Depart room to use The Relaxation room or continue to ready yourself in the restroom facilities

I Agree

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
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.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
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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