Open House

I acknowledge that massage should not be conducted under certain health conditions and accept that I am physically and emotionally comfortable enough to receive chair massage therapy sessions. All sessions are absolutely non-sexual and I will be given every effort to do no harm. However, I also agree that if I feel any pain or discomfort during the massage session, it is my sole responsibility to inform the massage therapist. I, also, will take full responsibility for my body and behavior and consent to release and indemnify staff and any claims or injuries associated with this or any future massage session. As a condition of and in consideration for receiving massage therapy services offered by Elemental Healing Arts Studio, LLC the undersigned hereby signs this Release and represents the following. 1. I hereby RELEASE, DISCHARGE, COVENANT NOT TO SUE, and HOLD HARMLESS Elemental Healing Arts Studio, LLC and its agents and officers, and all of its massage therapists (the “Releasees”) from all liability to the undersigned for any and all loss or damage, and any claim or cause of action, on account of injury to my person or property due to or resulting from the undersigned’s receipt of any massage therapy services being offered by the Releasees. 2. I acknowledge that my election to receive massage therapy is my personal decision and entirely voluntary. 3. I HEREBY ASSUME FULL RESPONSIBILITY FOR RISK OF BODILY INJURY RESULTING FROM MY RECEIVING MASSAGE THERAPY FROM EITHER SINGELI ZAPARANIUK LMT OR ANY MASSAGE THERAPIST CONTRACTED BY Elemental Healing Arts Studio, LLC TO PROVIDE THIS SERVICE. 4. I EXPRESSLY ACKNOWLEDGE that I am not currently suffering from any ailment that could adversely be affected by massage. Furthermore, if I experience any pain or discomfort during the massage, I will immediately notify the massage therapist so that the pressure methods can be adjusted to my comfort level. 5. This agreement is to be construed according to the laws of the State of Illinois and, if any portion hereof is held invalid, it is agreed that the remainder continues to have full force and legal effect. BY TYPING MY NAME BELOW, I ACKNOWLEDGE THAT I HAVE READ AND VOLUNTARILY SIGNED THIS RELEASE OF LIABILITY, AND I FURTHER AGREE THAT NO ORAL REPRESENTATIONS OR STATEMENTS OF INDUCEMENT APART FROM THIS WRITTEN AGREEMENT HAVE BEEN MADE TO ME. I HAVE READ THIS DOCUMENT, AND I UNDERSTAND IT IS A RELEASE OF ALL POTENTIAL CLAIMS. I UNDERSTAND THAT I ASSUME ALL RISKS INHERENT IN RECEIVING MASSAGE THERAPY. TYPE YOUR NAME BELOW TO AGREE TO THE TERMS LISTED ABOVE: