top of page
Log In
Liability Waiver
First Name
Last Name
Email
Date of Birth
Do you have a health consition that would limit you from recieving in intense physical massage?
No
Yes
Phone
Please specify anything we should know about
Initials
I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of recieving this deep tissue massage. I hereby assume all risks connected therewith and consent to participate in this service. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this massage.
Add answer here
Submit
Thanks for submitting!
bottom of page
.png)