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Disclaimer and Liability Release

BEMER HUMAN SETS USA

If you have any health issues please check with your Doctor for approval before receiving a Bemer session. 

BEMER is intended for use in the prevention and further therapy of diseases that are caused, accompanied or complicated
by microcirculatory issues due to reduced vasomotility.
Any other use is considered "not indicated on the label" and therefore prohibited.

BEMER does not provide any medical advice or service.
Nothing provided by BEMER in connection with the BEMER shall be construed to provide professional medical advice, diagnosis or treatment and you must not rely on or take it to the letter.
Before starting a health, protocol or starting to use a medical device such as BEMER or if you have any medical concerns, pre
-existing injuries or illness, please consult a licensed health care provider.


BEMER should not be used for organ transplantation, immunosuppressive therapy or pregnancy without first consulting a physician.

You agree that you understand these
limitations, have had the opportunity to obtain more information about
them and consult your doctor if you have any questions or concerns.
For more information, please consult the product manual or call

BEMER at 1-800-554-9117.

You hereby release and hold BEMER, its parent,
subsidiaries and affiliates and their officers, directors, employees, agents, attorneys, affiliates, partners, contractors, assigns
and permitted assigns (“us”) harmless from any and all loss, liability, damages, costs, claims, demands or causes of action
of any nature and kind, known or unknown, which you
or any third party has or may in the future have against us resulting directly or indirectly from your use of the BEMER products.
You agree that any claim you may have against BEMER
or a BEMER distributor related to your use of a BEMER product must be filed within one year after such claim arose; otherwise your claim is permanently barred.
By signing below, you acknowledge that you have the legal right
to perform this disclaimer and have read, understood and accepted all of the foregoing

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

Email*

Confirm Email*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
how did you hear of us?

Please share who referred you to us here. 

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 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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