Massage/ Facial Intake Form

Parent or Guardian's Email Address

Email*

Confirm Email*

Cancellation Policy

A CANCELLATION IS CONSIDERED LATE WHEN THE APPOINTMENT IS CANCELLED LESS THAT 48 HOURS BEFORE THE APPOINTMENT TIME. WE WILL CHARGE 50% FOR A LATE CANCELLATION. A NO-SHOW IS WHEN A MEMBER MISSES AN APPOINTMENT WITHOUT CANCELLING. WE WILL CHARGE THE MEMBER FULL PRICE FOR A NO-SHOW MISSED APPOINTMENT. OPTI-DOLLARS CAN BE CREDITED FOR THIS FEE. When you book your appointment, you are holding a space on our calendar that is no longer available to our other members. To be respectful of your fellow members, and service providers, please call The Rejuvenation Spa as soon as you know you will not be able to make your appointment. If cancellation is necessary, we require that you call at least 48 hours in advance. Appointments are in high demand, and your advanced notice will allow another member access to that appointment time. If you need to cancel your appointment, please call us at 316.927.2980. If necessary, you may leave a detailed voicemail message. We will return your call as soon as possible. *

I agree

Release of Liability Waiver

It is my choice to receive spa treatments. I realize that the treatment is being given for the well-being of my body and mind. I agree to communicate with my service provider any time I feel as though my well-being is being compromised. I understand that the service providers do not diagnose illness, disease, or any physical or mental disorder, nor do they prescribe medical treatment. I acknowledge that spa services are not a substitute for medical examination or diagnosis, and that it is recommended that I see a Health Care provider for that service. I understand and voluntarily accept the risks associated with ALL spa services, including but not limited to: Massage, Facials, Infrared Sauna, Waxing, Dermaplane Treatments, Oxygen Bar or the use of any of the location's facilities. I agree Rejuvenation Spa at Opti-Life will not be liable for death or any injury, including, without limitation, personal, bodily or mental injury, economic loss or damage to me resulting from negligence, other acts in the Rejuvenation Spa, anyone acting on Rejuvenation Spa's behalf, or anyone using the services of the facilities of Rejuvenation Spa at Opti-Life, to the fullest extent permitted by law. I agree that this application and waiver is in effect for ALL spa services and will not expire unless specifically requested by either party. I understand that Rejuvenation Spa at Opti-Life is a tranquil and professional environment and that any inappropriate behavior may result in termination of my services and full payment is expected. BY SIGNING THIS FORM, I AGREE TO THE ABOVE TERMS AND RELEASE REJUVENATION SPA AT OPTI-LIFE AND ITS EMPLOYEES FROM ANY LIABILITY. *

I agree

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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