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The following agreement is a waiver / release for the temporary use of a BEMER Pro system ("Device") from the below signed Independent BEMER Distributor (IBD) and the Borrower, as follows in this waiver. 

The following agreement is a waiver / release for the temporary use of a BEMER Pro system ("Device") from the below signed Independent BEMER Distributor (IBD) and the Borrower, as follows in this waiver. 

 

In consideration for use of the device, the Borrower agrees to pay the amount of $300 for the first week and a total of $450 for two weeks. After two weeks the equipment must all be returned for inspection and can then be renewed for additional time. 

Borrower hereby agrees to following:

Borrower will inspect the device prior to taking possession of it, and shall notify loaner if the device appears to be broken, malfunctioning, or otherwise unsafe. Borrower shall not take possession of the device if the borrower believes the device to be unsafe. 

Borrower acknowledges that he/she is taking possession of and will use the device "as is" and "with all faults", and that loaner (IBD) has disclaimed all warranties. There is no warranty that the device will be fit for a particular purpose. Borrower acknowledges that they assume all risks resulting from the loan and use of the device. 

Borrower will store and maintain the device only at the address listed above, and shall not remove the device from the address listed above to another address without the written consent of the loaner. 

Borrower will properly maintain and care for the device using the supplied surge protector at all times. Borrower will not make any modifications or repairs to the device. 

Borrower will not lend the device to any other individual, or allow any other individual to use the device in any manner. 

Borrower will obtain adequate liability insurance for the device, and will hold harmless and indemnify loaner from any claim of liability for any losses or damages allegedly caused by the device. 

Borrower hereby releases, discharges, indemnifies, and agrees not to sue loaner or any of its officers, directors, agents employees or insurers (the "Releases") on account of any injury, loss or damage, including death and damage to property, caused or alleged to be caused by the device, whether such injury or loss was caused or alleged to be caused in whole or in part by the negligence of the Releases or otherwise. 

Borrower will clean and return the device in the same condition as received, and agrees to pay for any damages or repairs up to and including the full replacement cost of the device, including shipping and tax. 

Borrower agrees to return the device no later than the agreed upon date which is no later than two weeks from the initial rental date. 

 December 5, 2020

BORROWER HAS READ AND AGREES TO THIS AGREEMENT, WAIVER AND RELEASE.

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
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
How long are you renting the BEMER for?*
1 Week for $350
2 Weeks for $450
Loaned BEMER: Installation Check list *
ALWAYS use supplied surge protector
Always cover B.Body with a sheet or towel
1/2 glass of water before AND after session
Know how open B.box
Know how to turn on and off B.box
Know how to adjust volume, time, etc
Know how to attach magnetic plugs
B.body and B.pad at same time
Can place B.body on top of body
Know how to use B.spot and B.light
Is NOT to be used with those on immune suppressant meds
If PREGNANT, check with their doctor before use
Know the buttons on the machine with confidence
Review recommended settings and time chart
Know program settings, Sleep Settings and Light settings
Know how to use B.SCAN
Know detox possibility
Call with ANY questions
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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