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General Information and Waiver of Liability


Please thoroughly read each of the following statements and sign the agreement below.

General Information


I Agree
 I understand that I must arrive 15 minutes before my appointment in order to allow for time to check-in.

I Agree
 I understand that if I am more than 5 minutes late, I will lose my appointment time and must reschedule.

I understand that if guests are booked under my name, I need to send this General Information and Waiver of Liability to them for their signature.

I understand that modalities within a circuit can not be split up and scheduled for different days.

I understand if I do not complete a circuit, I forfeit my payment.  Unusual circumstances will be taken in consideration on a case-by-case basis.

I understand that I need to vacate the Inception premises no later than 15 minutes after completion of my services in order to allow other clients to take advantage of the services and for the staff to clean the premises.

Waiver of Liability

I agree I have watched the Inception Explainer Video that was sent to me by email.

I agree that Inception does not diagnose, treat, cure, or prevent any physical diseases or mental health disorders.

I agree that the Inception modalities are not medical treatments.

I agree that Inception modalities have not been approved for any medical purpose by the FDA or any other governing agency.

I agree that the modalities are not used as a medical intervention.

I agree that it is not possible to predict what my central nervous system will do with the information it is offered while using the modalities and consequently there is no guarantee as to the results of the services.

I agree to cease using the modalities if I am less than happy with the results I am getting. 

I agree that I do not have any communicable or infectious disease, illness, open sore or skin disorder.

I agree that I am not under the influence of drugs or alcohol, or non-prescription medication.

I agree that I do not have a condition (nor am I receiving medical treatment, such as medication) that may be adversely affected by deep relaxation and/or immersion in an Epsom salt solution.

I agree I do not have untreated high (greater than 180/120) or low (less than 90/50) blood pressure.

I agree I am not diabetic with insulin dependency. If I am, I have written medical authorization to float.

I agree I do not have chronic heart or kidney disease. If I do, I have written medical authorization to float.

I agree I do not suffer from seizures or epilepsy. If I do, I have written medical authorization to float.

I agree I do not have schizophrenia or diagnosed claustrophobia. If I do, I have written medical authorization to float.

I agree if I am pregnant, I have written medical authorization to float.

I agree I am not allergic or skin-sensitive to hydrogen peroxide used as a sanitizing agent.

I agree I will not float with conditioner, oils, creams or other products on my body or hair, and I will remove all jewelry and contact lenses before floating.

I agree I feel well today, have no incontinence or nausea, and will only float when I feel well.

I Agree
 I agree that I havent dyed my hair within the last week

I agree that the floatation tank contains a concentrated magnesium sulfate (Epsom Salt) solution, which help inhibit the growth of most bacteria. After EVERY session, the water in the tank goes through a powerful filtration system, and then is treated by an Ozonator, which uses the power of ozone to disinfect the water before it goes back into the tank. Hydrogen peroxide is also added daily.

I agree that individual experiences with floating are varied and unique, and I take full responsibility for any of my thoughts and actions while in the floatation tank as well as after my floatation experience.

To the best of my knowledge, I have been completely forthright in this agreement.

I agree to not hold Inception-Farmington Hills, LLC or any of its owners, employees, and all agents responsible for a less than desired outcome that may be considered negative.

I agree to irrevocably hold harmless and waive any claims that I now may have or may have hereafter against Inception-Farmington Hills, LLC or any of its owners, employees, and all agents. 

This waiver of liability and all agreements made herein shall apply to each and every use of all the modalities at Inception.

I have read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability in connection with the use of the modalities, facilities, including the entire interior of the premises operated by Inception-Farmington Hills, including the Inception's owners, employees, and all agents, whether such loss or damage, be it direct or indirect, to the greatest extent allowed by the law in the State of Michigan. I understand that if I do something that causes damage to any of the equipment, their contents, or other areas and contents within the Inception's premises, I am financially responsible to fully cover said damages and/or losses.

First Clients Name

First Name*

Middle Name

Last Name*

Phone*
First Clients Date of Birth*
First Clients Signature*
Second Clients Name

First Name*

Middle Name

Last Name*
Second Clients Date of Birth*
Third Clients Name

First Name*

Middle Name

Last Name*
Third Clients Date of Birth*
Fourth Clients Name

First Name*

Middle Name

Last Name*
Fourth Clients Date of Birth*
Fifth Clients Name

First Name*

Middle Name

Last Name*
Fifth Clients Date of Birth*
Sixth Clients Name

First Name*

Middle Name

Last Name*
Sixth Clients Date of Birth*
Seventh Clients Name

First Name*

Middle Name

Last Name*
Seventh Clients Date of Birth*
Eighth Clients Name

First Name*

Middle Name

Last Name*
Eighth Clients Date of Birth*
Ninth Clients Name

First Name*

Middle Name

Last Name*
Ninth Clients Date of Birth*
Tenth Clients Name

First Name*

Middle Name

Last Name*
Tenth Clients Date of Birth*
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.

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*

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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