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Super Human Institute of Technology
Please read carefully as this effects your legal rights

I, hereby acknowledge that I have voluntarily chosen to participate in wellness and longevity therapies at the United Rehab Specialist, LLC dba Super Human Institute of Technology (hereinafter referred to as "the Institute"). The Institute offers various therapies, which I may select to use including but not limited to:

Red light therapy

Hydromassage therapy

Vibration plate

PEMF mats

HALO therapy

Hyperbaric oxygen therapy

EWOT therapy

Steam Sauna

Infrared Sauna therapy

Cold/Cro plunge therapy

Vibroacoustic therapy

Hydrogen Water

Class 4 Cold Laser

I understand that participating in these therapies involves certain inherent risks, and I agree to the terms outlined in this agreement.

Acknowledgment of Risks

I am aware that participating in the therapies offered by the Institute involves certain inherent risks, including but not limited to physical injury, illness, or adverse reactions. These risks may arise from:

The use of equipment or facilities

The physical environment

The nature of the therapies themselves

Specific risks associated with the therapies include, but are not limited to:

Eye damage from light therapies if proper eye protection is not used.

Slips, falls, or accidents in wet or slippery areas.

Dizziness or loss of balance from vibration or movement-based therapies

Interference with medical devices or implants, such as pacemakers

Respiratory irritation from inhaled substances, such as salt particles

Barotrauma or oxygen toxicity from hyperbaric oxygen therapies

Overexertion or strain from exercise-based therapies

Heat-related illnesses, such as dehydration, heat exhaustion, or heat stroke.

Cold-related issues, such as hypothermia or shock from sudden temperature changes Sensory discomfort or overload from sound or vibration therapies

I acknowledge that this list is not exhaustive, and other unforeseen risks may exist. I understand that while the Institute takes measures to ensure safety, it cannot eliminate all risks associated with participation.

Release of Liability

In consideration of being permitted to use the Institute's facilities and services, I hereby release, waive, discharge, and covenant not to sue United Rehab Specialist, LLC dba the Super Human Institute of Technology, its owners, assignees, employees, volunteers, contractors, and landlords (collectively, "the Released Parties") from any and all liability, claims, demands, actions, or causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that I may sustain while participating in the therapies or being on the Institute's premises.

This release extends to all claims, whether caused by the negligence of the Released Parties or otherwise, to the fullest extent permitted by law. I understand that this waiver does not apply to liabilities arising from gross negligence or intentional misconduct by the Released Parties.

Assumption of Risk

I voluntarily assume all risks associated with my participation in the therapies, whether known or unknown, and accept full responsibility for any injury, illness, damage, or loss I may suffer as a result of my participation.

Health Representation

I represent that I am in good physical health and have no medical conditions that would prevent me from safely participating in the therapies offered by the Institute. If I have any medical conditions, allergies, or concerns that may affect my ability to safely participate, I have consulted with a healthcare professional and have been cleared to participate.

I agree to inform the Institute's staff of any medical conditions, allergies, or concerns that may affect my participation. I understand that the Institute relies on the accuracy of the information I provide.

Indemnification

I agree to indemnify and hold harmless the Released Parties from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities, including attorney's fees, brought as a result of my participation in the therapies or any third-party claims arising therefrom.

Agreement to Follow Rules and Safety Protocols

I agree to follow all instructions, guidelines, and safety protocols provided by the Institute's staff. I understand that failure to do so may increase the risk of injury and may result in my removal from the premises.

I agree to use all equipment and facilities in a safe and proper manner, following all instructions and warnings provided. I understand that misuse of equipment may result in injury and that I am solely responsible for any such misuse.

Right to Refuse or Discontinue Participation

I understand that I have the right to refuse any therapy or to discontinue participation at any time if I feel uncomfortable or unsafe. I agree to communicate any concerns to the Institute's staff immediately.

Acknowledgment of Understanding

I have read this Liability Waiver and Assumption of Risk agreement and fully understand its terms. I am signing this agreement freely and voluntarily, without any inducement or assurance of any nature. I have had the opportunity to ask questions about the therapies and the risks involved, and I am satisfied with the responses received.

I understand that this waiver applies to my current and future use of the Institute's services unless revoked in writing.

Age and Competency

I am at least 18 years of age and legally competent to sign this agreement. If I am signing on behalf of a minor, I represent that I am the parent or legal guardian of the minor and have the authority to sign this agreement on their behalf.

Severability

If any provision of this agreement is found to be unenforceable or invalid, the remaining provisions shall remain in full force and effect.

Governing Law

This agreement shall be governed by and construed in accordance with the laws of North Carolina, USA, without regard to its conflict of law principles.

Date: March 14, 2025

First Participant's Name

First Name*

Last Name*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's 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*

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.


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