Float Waiver

To be legally allowed to float, you MUST complete the below waiver prior to every appointment.

Waiver Float

First Name

Last Name

Age

Date of Birth

Phone/Mobile

Emergency Contact Name

Emergency Contact Phone

Address

Address Line 1

City

State

Zip Code

Floatation Meditation Therapy provides a deep state of relaxation that stimulates blood flow through all of the bodies tissues, releases natural endorphins, and the brain gives out alpha waves associated with relaxation and meditation. To ensure a comfortable, clean, and safe Meditation Floatation experience, I agree to the following (Please check each statement).

I do not have any communicable or infectious disease, illness, or skin disorder.

I do not have a history of high (>= 180/120) or low (<=90/50) blood pressure.

I am not diabetic with an insulin dependency.

I do not have kidney disease.

I do not suffer from uncontrolled seizures or epilepsy.

I am not currently menstruating.

I have consulted with and secured written permission from my physician to use the Floatation Pools if I am pregnant.

I understand the Floatation Pool uses: Pharmaceutical grade Epson Salts, Ultraviolet sterilization system, Natural enzymes and non-toxic biodegradable cleaning products and Hydrogen Peroxide.

I further understand that each individual may have a unique experience. I have been given an orientation which familiarized me with the safe and appropriate use of the tank/pool. I agree to take full responsibility for my thoughts and actions while in the floatation pool and the waiver of the liability and all agreements made herein shall apply to each and every use of the floatation pool.

I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Solace Relaxation Massage, LLC and its employees and agents. I have read and fully understand and agree to the above terms of this unconditional release of all liability to the greatest extent allowed by law in the state of Ohio. Please legibly type the following sentence, repeat your name and sign below:

“I have read in its entirety and fully understand this Floatation Meditation Waiver”.

First Name

Last Name

Today's Date

Signature

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Float Waiver

Solace Relaxation Massage, Float Spa & Esthetics

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