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FLOATATION WAIVER




FLOATATION THERAPY SESSIONS

 

I agree to NOT use the float pod under any of the following circumstances:

 

- If I have not showered thoroughly with the provided "pre-float" body wash provided by our spa to remove any creams, oils, or makeup

- If I have had any hair color/treatment within the past two weeks, or have any hair color that would bleed into the water or onto a white towel. We are more concerned about the temporary dye that washes out and would stain the water.

- If I am under the Influence of drugs or alcohol

- If I have a communicable or Infectious skin condition, disorder, or disease

- If I have open sores

- If I am diabetic, unless my diabetes is under medical control

- If I have a history of heart trouble, epilepsy, seizures, or blackouts, and have not received my doctor's (written) permission to use the float pod

- If I am menstruating or experiencing some other sort of external vaginal Issues

- If I have a condition that may be adversely affected by cutaneous absorption of magnesium

- If I have kidney disease and have not received my doctor's (written) permission to use the float pod

- If I may release bodily fluids, voluntarily or involuntarily, into the float pod

Please note: Our staff is not trained in assisted transfers. If you need help getting in or out of the float pod, you should bring your own helper.

SWIMSUITS ARE DISCOURAGED. Would you wear a swimsuit in your bathtub?

 

>> I have read and understand all the terms listed above. I understand that violation of any of these rules that result in contamination of the float pod water may result in a cleaning and salt replacement fee of up to $1000.



 

CANCELLATION POLICY

 

 I agree to the 48-hour cancellation policy. If I am a No-Show or last-minute cancellation, I agree to pay for my service in full. If a gift certificate was used to reserve my spot, the voucher will be redeemed. Cancellation must be by phone or email at least 48 hours before my service. I understand my service starts at the designated appointment time, and if I am late, my service will be shortened to not affect the next person after me.



First Client Name
First Name*
Last Name*
Phone*
First Client Date of Birth*
Date of Birth
First Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
First Client Signature*
Second Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Second Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Third Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Third Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Fourth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Fourth Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Fifth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Fifth Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Sixth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Sixth Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Seventh Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Seventh Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Eighth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Eighth Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Ninth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Ninth Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
Tenth Client Name
First Name*
Last Name*
Client Date of Birth*
Date of Birth
Tenth Client Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
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 Date of Birth*
Date of Birth
Parent or Guardian's Information
I agree to pay for my full float session even if I exit before the full time. Once you enter the room, it is considered a full session. Floating is not for everyone. We expect payment for services rendered no matter how long your session is.*
Yes
Do you have a Gift card or Gift certificate?*
No
Yes
If yes, how much is the gift amount? *
Are you currently pregnant?*
No
Yes
If yes, how far along?
Any high risk factors?
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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