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Infrared/Traditional Sauna Waiver and Release of Liability Form

Drink plenty of water before, during and after your session.
If you experience pain and/or discomfort, immediately discontinue and exit the sauna
If you are on medications, consult with your doctor before using the infrared sauna.
Do no use drugs, tobacco or alcohol prior to or during the sauna session.
No one under the age of 18 is permitted in the infrared sauna.
If you have a medical condition or are on any prescription medications, consult with your physician before using the infrared sauna
Discontinue the use of the sauna if you feel light-headed, dizzy, heat exhausted, or unwell.

I acknowledge and accept the risks inherent in the use of the infrared sauna. I voluntarily assume the risk of injury, accident or death, which may arise from the use of the infrared sauna. I an any of my heirs, executors’ representatives or assigns hereby release from all claims or liabilities for personal injury or property damages of any kind sustained while on the premises, during the use of the infrared sauna and from any advice provided by an employee or any representative. I agree that this release is in effect for all infrared sauna sessions.

None of the information provided is intended to act as a substitute for medical advice, nor does it involve the diagnosis, prognosis, or prescription of remedies for the treatment or prevention of any disease or ailment.

I certify that everything on this form is true and correct to the best of my knowledge. I also understand that the infrared sauna is not intended to diagnose, treat, cure, or prevent any disease or ailment.

Today's Date: January 22, 2022 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Third Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Fourth Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Fifth Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Sixth Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Seventh Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Eighth Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Ninth Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Tenth Participant's Name

First Name*

Middle Name

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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

Participant'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

Emergency Contact's Name*

Emergency Contact's Phone Number*
How did you hear about The Care Collective?

How did you hear about The Care Collective?
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

Primary Physician/Providers *
Have you ever used an infrared sauna before?*
No
Yes

Please list any allergies you may have

Is there anything else you feel I should know?
Do you have a heart pacemaker or any other battery operated or electrical implant?*
No
Yes
Are you pregnant or breastfeeding?*
No
Yes
Do you currently have a fever, infection or injury?*
No
Yes
Have you recently had high blood pressure, a heart attack or other cardiovascular problems?*
No
Yes
Do you have a history of dizziness, fainting spells, heat sensitivity narcolepsy or seizures?*
No
Yes
Do you suffer from any bleeding disorders?*
No
Yes

****If you answered YES to any of these questions, it is not recommended that you use the infrared sauna at this time. We suggest that you consult your Primary Health Care Physician to obtain a release form before proceeding with infrared sauna therapy.*** 

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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