Waiver Name(Required) First Last Additional Names First Phone(Required)Email(Required) Waiver CRYOTHERAPY Whole Body Cryotherapy (WBC) involves exposure to extreme cold temperature for a time not to exceed 3 minutes per session to create a systemic, anti-inflammatory response in the body. You will be attended to by a Chillax Recovery LLC, Trained technician during the entire process of the WBC session and can indicate an end to the session at any time before the agreed time duration. WBC has a risk of skin irritation due to the extreme cold temperatures. This risk is minimized greatly, and mostly eliminated by following the technician's instructions and protocol. INFRARED SAUNA Infrared sauna is a sauna that uses infrared rays to heat up the sauna and the client. The sessions are 30 min long but you are free to end the sessions at anytime. You will be exposed to elevated temperatures but are completely safe by following the technicians instructions and protocols. HYPERBARIC CHAMBER Hyperbaric oxygen chamber therapy is intended to enhance, not replace any drugs or treatment program prescribed or recommended by a physician or health professional. The portable hyperbaric chamber is FDA approved only for AMS (Acute Mountain Sickness) also known as Hypoxia and Altitude Sickness. Many health care practitioners use the hyperbaric chamber to improve other health issues. However, I understand that the use of the chamber is not intended to diagnose, treat, or cure or prevent any disease. I attest that I am consenting adult over the age of 18 and that I agree to enter (and/or permit my child to enter) the hyperbaric chamber of my own free will, without coercion or sales pressure from any associate or employee of Chillax Recovery LLC. I understand that there is no guarantee to any positive physical or emotional response to this therapy, and that fees are for services rendered and not benefits received. I procure this therapy at my own risk. I realize that I may not observe nor realize any benefit from the hyperbaric treatment. I understand that the amount of atmospheric pressure used by Chillax Recovery LLC is 2.0 absolute atmospheres. I understand and agree that even though there are over 2,000 portable hyperbaric chambers in service today with a flawless safety record, I am entering the chamber at my own risk. I hold Chillax Recovery LLC harmless of any adverse effects that may arise as a result of the hyperbaric chamber therapy. Among various complaints experienced by persons undergoing hyperbaric oxygen chamber therapy is minor ear or sinus discomfort, although the complaints are not limited this kind of discomfort. The hyperbaric health care professional works with the client or parent of the client to provide comfort in the event of any discomfort that may be experienced by the client. This agreement is not intended to set fourth each and every discomfort or effect as might be experienced by a client partaking of hyperbaric oxygen chamber therapy. Chillax Recovery LLC is not a medical facility, and there are no persons on our staff licensed as a medical personnel capable of rendering an opinion or making a diagnosis or prognosis respecting either the state of the client’s health or the physical, emotional or medical effects of hyperbaric oxygen therapy. I am not aware of any physical condition of which I suffer or have that would or should preclude me undertaking this therapy. If I have any doubts, concerns or questions, I will, prior to undertaking such therapy, seek and obtain medical advice. I attest to the fact that I have read this agreement and fully understand and comprehend this agreement in its entirety. I understand that by signing this agreement, I am assuming any and all risk associated with the administration of pressure hyperbaric oxygen therapy. You applied for and voluntarily elected to bring in personal property into the hyperbaric oxygen chamber. Participant understands that during the course of such activity, Chillax Recovery LLC holds no responsibility for any damage to any personal property brought into the hyperbaric oxygen chamber. IT IS THE INTENTION OF PARTICIPANT BY SIGNING BELOW TO EXPRESSLY ASSUME ALL RISK OF PERSONAL PROPERTY DAMAGE UPON THEMSELF, AND TO EXEMPT AND RELIEVE THE CHILLAX RECOVERY RELEASES FROM LIABILITY FOR PERSONAL PROPERTY DAMAGE. By signing this release, participant acknowledges that it is not advised to bring in any electronics into the hyperbaric oxygen chamber. Participant waives his/ her right to bring any legal action now or at any time in the future to recover compensation or obtain any other remedy for any injury to his/ her property. However caused, arising out his/ her spouse (if any), assignees, heirs, parents, guardians, and legal representatives will not make any claims against, sue or attach the property of Chillax Recovery LLC releases for any loss or damage resulting from participants participation in the activity. Participant is aware of the potential dangers incidental to engaging in the activity, that this is a release of liability, a waiver between participant and the Chillax Recovery LLC releases, and participant signs it of his/ her own free will. Participant expressly agrees that if any portion is held invalid, agrees that the balance shall, not withstanding, continue in full force and effect. Listed below are CONTRAINDICATIONS of which, if you say YES to any of these, you are UNABLE to participate in a Whole Body Cryotherapy/Infrared session/Hyperbaric Chamber. Uncontrolled High Blood Pressure (Systolic of 180 or above) Heart Attack Heart Disease or Stroke Deep Vein Thrombosis (blood clots) Pregnancy Reynaud's Syndrome* Cold Allergy or Sensitivity* Recent open wounds or surgery* which hasn't healed or any other Serious Medical Condition (if you are unsure, please consult your physician before scheduling a WBC session) Liability and Medical Release In consideration of permitting Chillax Recovery LLC to administer Whole Body Cryotherapy, infrared sauna and/or massage, I hereby waive any and all claims and damages for personal injury as a result of my participation. I understand and agree that: This release is intended to discharge, in advance, Chillax Recovery LLC, its' officers, officials, employees, agents and volunteers from and against all liability arising out of, or connected in any way with my participation of these activities. I agree to communicate any issues or reactions to the session with the technician or owners in a timely manner so that it may be addressed directly. Knowing the risks involved and the contraindications related, I choose voluntarily to request permission to participate. I indemnify and hold harmless Chillax Recovery LLC, its' owners, officers, officials, employees and volunteers from any loss, liability, damage, cost or expense, including litigation of any form, arising out of or connected in any manner with my participation in such activities. I am in good health and have no physical condition expressed in the CONTRAINDICATIONS or otherwise which would preclude me from safely participating in such activities. I understand and agree that this release is intended to be as broad and inclusive as permitted under Utah law and that if any portion of this release and waiver should be determined to be invalid, it is my intent that the remaining provisions shall continue in full force and effect. Initial that I have read and agree to the above.Waiver I affirm that I have stated all of my known medical conditions and answered all questions honestly. I agree to keep the practitioner updated as to any changes in my medical profile and understand that there shall be no liability on the practitioner's part should I fail to do so. I also understand that any illicit or sexually suggestive remarks or advances made by me will result in immediate termination of the session,, and I will be liable for payment of the scheduled appointment. Understanding all of this, I give my consent to receive care.I have read and agreed to the above staments.(Required) I agree Permission to use photograph/video (optional) I have read to and agree to the followingI grant to Chillax LLC, its representatives and employees the right to take or use photographs/video of me and my property in connection with the above-identified subject. I authorize Chillax!, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Chillax May use such photographs of me with or without my name and for any lawful purpose, including for example such purpose as publicity, illustration, advertising, and web content.Signature(Required)Sign your first and last name below as your representation that you have read and agree to this waiver in its entirety. (Signature of Parent or Guardian for clients under the age of 18)Date(Required)