Float Therapy Waiver

 

WAIVER, INDEMNIFICATION, AGREEMENT FORM

Welcome to The Chicago Stress Relief Center! We hope you enjoy your time here. Floating can promote significant mental and physical relaxation, as well as other benefits. The purpose of this form is to ensure that your floating experience is safe and enjoyable. This form covers important topics, so please read it thoroughly before signing.

General Information

Floatation takes place in a floatation room containing a solution of water and Epsom salt. The solution is calibrated to body temperature and is regularly filtered to maximize cleanliness. Your float will last 60 or 90 minutes, and an automatic filtration will turn on notifying you that your time is up. If you do not hear the filtration system turn on, our office staff will knock on the door to remind you that it is time to get out. Due to the high salt content of the solution, it is important that you not allow the solution to come into contact with your eyes. Bathing suits are not necessary and might be damaged by the Epsom salt.

The Chicago Stress Relief Center’s Rules

1. EXCULPATORY CLAUSE. In consideration for receiving permission to use Ocean Float Room and Shower Usage (herein referred to as “activity”), which is sponsored by The Chicago Stress Relief Center, Inc. (herein referred to as “sponsor”), the Participant understands water is involved and can be slippery when on the ground/floor and/or in and around the Ocean Float Room and shower. I further understand that the shower floor and floor leading to the Ocean Float Room and shower get wet from time to time and water does cause surface area to become slippery. I hereby release, waive, discharge, covenant not to sue, and agree to hold harmless for any and all purposes sponsor, The Chicago Stress Relief Center, Inc. and their members, officers, servants, agents, volunteers, or employees (herein referred to as RELEASEES or INDEMNITEES) from any and all liabilities, claims, demands, injuries (including death), or damages, including court costs and attorney’s fees and expenses, that may be sustained by me while participating in such activity, or while on the premises owned or leased by RELEASEES, including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence parse, statutory fault, or strict liability of RELEASEES.
2. INDEMNITY CLAUSE. I am fully aware that there are inherent risks to myself and others involved with this activity and I choose to voluntarily participate in said activity with full knowledge that the activity may be hazardous to me and my property, and to the person and property of others. I know of no medical reason why I should not participate. / agree to indemnify and hold harmless INDEMNITEES from any and all liabilities, claims, demands, injuries (including death), or damages, including court costs and attorney’s fees and expenses, which may occur to myself, other participants, and third-persons as a result of my participation in said activity, including injuries sustained as a result of the sole, joint, or concurrent negligence, negligence per se, statutory fault, or strict liability of INDEMNITEES.
3. NO INSURANCE. I understand that RELEASEES may not maintain any insurance policy covering any circumstance arising from my participation in this activity or any event related to that participation. As such, I am aware that I should review my personal insurance coverage.
4. BIND HEIRS. It is my express intent that this agreement shall bind the members of my family and my spouse, if I am alive, and my heirs, assigns and personal representatives, if I am deceased, and shall be governed by the laws of the State of Illinois.
5. VOLUNTARY SIGNATURE. In signing this agreement, I acknowledge and represent that this agreement BINDS HEIRS. It is my express intent that this agreement shall bind the members of my family and read it, understand it, and sign it voluntarily as my own free act and deed; The Chicago Stress Relief Center, Inc. has not made, and I have not relied on any oral representations, statements, or inducements apart from the terms contained in this agreement. I execute this document for full, adequate and complete consideration fully intending to be bound by the same, now and in the future. I understand I can choose not to sign this document and free myself from its terms and the associated risks of the activity by simply not participating in the activity and choosing some other activity available to me that has a lower level of risk to me.
6. Please remove all Jewelry and contact lenses before using the tank. If you have swimmers ear, are prone to ear infections or any inner ear condition that may be irritated by salt and water, please be sure to wear the earplugs provided for you. Wash thoroughly before entering the tank. Chicago Stress Relief Center, Inc. its agents and or assigns are not responsible for lost or stolen items.

The Float Rules

• Use caution in the float room and when entering on exiting the Float Unit or shower. Your feet and the floor surfaces may be wet and slippery.
• Shower before and after your float.
• Do not wear jewelry while you are floating.
• Do not eat, drink or smoke while in the Float Unit or float room.
• Use the earplugs provided.
• Follow all other rules and instructions provided by our personnel.

DO NOT ENTER THE FLOAT ROOM IF YOU:

1. Are epileptic or have a related illness
2. Are under the influence of drugs or alcohol
3. Have infectious diseases, open skin wounds, or suicidal tendencies
4. Are pregnant and have NOT consulted with a physician

I fully understand that I am responsible for any and all medical conditions while in the tank/shower area.

I recognize that I am fully responsible for my actions while in the tank/shower area.

I will pay a cleaning fee of at least $1200 on the day of incident should I voluntarily or involuntarily defecate, urinate or discharge any other bodily fluid in the Float Room and my credit or debit card, if on file, will be charged automatically, or a bill to my account will be made now due, if not on file. This is required to offset the loss of having to shut down the Float Room in order to clean it.

SIGNING THIS DOCUMENT INVOLVES THE WAIVER OF VALUABLE LEGAL RIGHTS. CONSULT YOUR ATTORNEY BEFORE SIGNING THIS DOCUMENT.

 

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