Loading...

MASSAGE & ART MASSAGE

WAIVER


Read entire waiver thoroughly before agreeing and signing


WAIVERS AND COVID 19, AUTOPAY, and TERMS & AGREEMENTS

MASSAGE/ART MASSAGE & GENERAL WAIVER

I have met with and received an instructional consultation about massage therapy and do hereby understand and acknowledge that receiving massage therapy may expose me to inherent risks, including but not limited to accidents, injury, or even death. I assume all risks associated with participation in this activity at RISE Bodyworks.

I Agree

I hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in such activity. I acknowledge that I am physically able and mentally capable of receiving massage therapy at RISE Bodyworks.

I Agree

After having read this waiver in its entirety and understanding these facts, and in consideration of acceptance of my participation and Rise Bodyworks furnishing its services to me. I agree that I, and anyone else entitled to act on my behalf, will hold harmless, waive, and release RISE Bodyworks, its employees, representatives, etc. from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in receiving massage therapy.

I Agree

I understand that these injuries or outcomes may arise from my own or others' negligence, conditions related to travel, or the condition of the location(s). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this Activity, including travel to, from and during this Care. I hereby release RISE Bodyworks and their directors, affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns.

I Agree

I agree to indemnify and hold harmless RISE Bodyworks against any and all claims suits or actions of any kind whatsoever for liability, damages, compensation or otherwise caused by me or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by or against me or by or against anyone else acting on my behalf. If RISE Bodyworks incurs any of these types of expenses, I agree to reimburse RISE Bodyworks.

I Agree

COVID 19 WAIVER 

RISE Bodyworks is open for use by other individuals, I recognize that I am at higher risk of contracting COVID-19. With full awareness and appreciation of the risks involved, I, for myself and on behalf of my family, spouse, estate, heroes, executors, administrators, assigns, and personal representatives, hereby forever release, waive, discharge, and covenant not to sue RISE BODYWORKS, its’ staff, owners, constituents and contractors, from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me related to COVID-19 whether caused by the negligence of the Released Parties, any third-party using RISE facilities or otherwise, while participating in any activity while in, on or around the RISE facilities, tools, equipment, machines, or materials. I VOLUNTARY AGREE IT IS MY INTENTION TO EXEMPT AND RELIEVE RISE BODYWORKS, its’ staff, owners, constituents and contractors, FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR ANY OTHER CAUSE. I agree to comply with all RISE BODYWORKS policies and rules, including but not limited to all RISE BODYWORKS guidelines, recommendations for safety, signage and instructions related to COVID 19 mandates and precautions. I agree that I am personally responsible for my safety and actions while using the facilities at RISE BODYWORKS.

I Agree

FACILITY USE POLICY (AGREEMENT)

All members using the RISE Bodyworks, Wellness Center Clinic will only be able to do so once they have a valid account in our MindBody system, have signed and authorized all terms/agreements and waivers

I Agree

Clinic patients must pre-register for their appointments using our online system.

I Agree

Adhere to ALL new and existing signage throughout the building and on the front door of RISE Bodyworks

I Agree

Adhere to all RISE staff requests & instructions verbally provided to you. It’s not acceptable to disregard instructions given to you by any staff person. Hostile behavior towards the staff will result in permanent membership cancellation

I Agree

Failure to comply with any RISE Bodyworks policy, request or instructions will be asked to leave the building and/or membership cancelled. RISE Bodyworks is required to follow all mandates from Alameda County and the State of California, and implements these requirements for the health of and safety of our members, patients, and our staff

I Agree

TERMS AND AGREEMENTS

 All Memberships:

●      I understand that I am purchasing an ongoing autopay (e.g. gym, class or massage) membership and I will be charged monthly until I cancel in person and have completed the cancellation form.

●      I authorize Rise Bodyworks to process the automatic payment every month, on the anniversary date of the initial purchase.

●      I understand that all monthly memberships have a minimum two-month commitment.

●      I understand that I must give a 30-day advance notice of cancellation.

●      I agree to keep a valid credit card on file.

●      I agree to reconcile any accrued charges on my account as a result of declined auto payments.

●      I agree that I am solely responsible to book and manage my appointments and classes, I take responsibility for all bookings even those I request be booked for me by Rise Bodyworks staff.

The undersigned understands and agrees to all of the above terms and agreements for ALL MEMBERSHIPS POLICY 

 

 Membership Cancellation:

●      I understand I may cancel my membership following the two-month commitment.

●      I agree to give 30 DAYS ADVANCE NOTICE from the next billing date.

●      I understand all cancellation requests must be done in person. I agree to come in person and complete the cancellation form provided by Rise Bodyworks

●      I understand that RISE Bodyworks will regard my membership as active if I do not adhere to the above process.

●      If I do not provide a 30-day advance notice, I authorize Rise Bodyworks to charge my credit card on file for the additional billing cycle.

The undersigned understands and agrees to all of the above terms and agreements for MEMBERSHIP CANCELLATION POLICY

 

Membership Suspension:

●      Gym Membership: I understand I can pause my membership for a minimum of 30 days and a maximum of 90 days. I agree to a $20 charge per month for all holds/suspensions. I hereby authorize RISE Bodyworks to process a monthly suspension payment for the duration of the hold, and I understand that I will begin regular payments at the end of my hold cycle. Holds must be requested via email prior to the next billing cycle. Holds are placed per billing cycle; prorated fees are not available.

●      Class & Massage Membership: I understand I can pause my membership for a minimum of 14 days and a maximum of 90 days.

 The undersigned understands and agrees to all of the above terms and agreements for MEMBERSHIP SUSPENSION POLICY

  

All Service Appointments

●      I agree to maintain an active and up to date account in the Rise Bodyworks online booking system, including a valid Credit Card on file.

●      I understand that I am fully responsible for booking my own clinic, massage, private session, and any other service appointments.

●      I agree to manage my booked appointments, even if they are booked by the Front Desk staff.

●      I agree to immediately report to the Front Desk staff any discrepancy found in a booked appointment, as I am responsible for all appointments made in my account.

 The undersigned understands and agrees to all of the above terms and agreements for ALL SERVICE APPOINTMENTS POLICY

 

Class & Appointment Cancellation Policy

●      I understand that all my booked classes and service appointments have a 12-hour cancellation policy.

●      I understand that if I cancel in less than 12 hours, I will be charged the full price of the class and/or service appointment.

●      I understand that if I have an unlimited class membership, a late cancellation or no show will result in a fee of $20 per class.

●      I understand that there are no exceptions to this policy including illness, unexpected travel, etc.

 The undersigned understands and agrees to all of the above terms and agreements for CLASS & APPOINTMENT CANCELLATION POLICY 

 

Refunds:

●      I understand there are NO partial or full refunds or account credits for memberships, services or products.

●      I understand that all sales are final.

●      I understand there are no exceptions to this policy including illness, unexpected travel, etc.

The undersigned understands and agrees to all of the above terms and agreements for REFUNDS POLICY 

 

Communications

●      I understand that I am required to maintain an active email address on record with Rise Bodyworks to ensure open communication regarding, but not limited to, emergencies, forces of nature, the Rise schedule, my account, operations and/or crucial updates.

●      I understand that it is my responsibility to ensure that risebodyworks@gmail.com is an approved contact in my email account and that Rise Bodyworks is not responsible for their emails being sent to Spam or Promotions.

●      I understand and accept the fact that if I unsubscribe to email notifications from Rise Bodyworks, I will not receive class and appointment confirmations and reminders and emailed receipts.

●      I understand that Rise Bodyworks will communicate with me via email and social media to ensure crucial updates are disseminated and received by Rise’s valued members, patients, and clients. In the event of a national, global emergency/disaster Rise must have my current contact information.

 The undersigned understands and agrees to all of the above terms and agreements for COMMUNICATIONS POLICY 

 

Use of Photo/Video Onsite

●      I agree to have Rise Bodyworks take my photograph for my account to allow for check-in membership verification.

●      I agree that Rise Bodyworks has my permission to use my likeness in a photograph, video, or other digital media in any and all of its publications, without payment, or other consideration.

●      I understand that all media will be used solely for Rise Bodyworks’ business marketing purposes.

●      I understand that I have the option to request not to be photographed at any time, by either asking the photographer, staff, or front desk.

The undersigned understands and agrees to all of the above terms and agreements for PHOTO/VIDEO ONSITE POLICY 

 

The undersigned understands and agrees to the above stipulations, terms and agreements:

Dated: February 28, 2024

 



 


First Client’s Name

First Name*

Last Name*

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

First Name*

Last Name*
Second Client’s Date of Birth*
Third Client’s Name

First Name*

Last Name*
Third Client’s Date of Birth*
Fourth Client’s Name

First Name*

Last Name*
Fourth Client’s Date of Birth*
Fifth Client’s Name

First Name*

Last Name*
Fifth Client’s Date of Birth*
Sixth Client’s Name

First Name*

Last Name*
Sixth Client’s Date of Birth*
Seventh Client’s Name

First Name*

Last Name*
Seventh Client’s Date of Birth*
Eighth Client’s Name

First Name*

Last Name*
Eighth Client’s Date of Birth*
Ninth Client’s Name

First Name*

Last Name*
Ninth Client’s Date of Birth*
Tenth Client’s Name

First Name*

Last Name*
Tenth Client’s Date of Birth*
Client’s 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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last 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.


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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!