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ASSUMPTION OF RISK AND LIABILITY WAIVER FORM

This Assumption of Risk and Liability Waiver (hereinafter referred to as the "Waiver") is entered into by and between Brain Revamp Clinic, LLC, doing business as BRC Mind and Body Wellness Spa; located at 7910 SW 57th Avenue, Suite 24, South Miami, FL 33143; Email: angelica@brcmindandbodywellness.com (“Service Provider”) and the

undersigned Client (“I”, “me”, or “Client”).

This Waiver applies to all services and equipment offered by the Service Provider, including but not limited to the Red Light Chamber, Cryo Chamber, Far-Infrared PEMF Sauna, Mild-Hyperbaric Chamber, and Vibroacoustic Lounger.

I acknowledge that I have voluntarily chosen to participate in these services and that I accept full responsibility for any risks or consequences that may come from my participation. By signing this forms, I voluntarily assume all risks associated with participating in these services and waive any claims against the Service Provider as specified below.

1. Acknowledgement of Eligibility:

I confirm that I am at least 16 years of age, and have obtained the

consent of my parent or legal guardian, who has also signed this Waiver on my behalf. I confirm that I am in good physical and mental health and that I have no medical conditions, symptoms, or concerns that would prevent me from safely participating in the wellness and recovery services being offered. I understand that it is my responsibility to inform the staff of any relevant health conditions before using any equipment or service. I understand that participation in any service while knowingly having a medical condition or contraindication is done at my own risk.

2. Services Description and Informed Consent:

I understand that the services are non-invasive and intended to support wellness through methods like light therapy, cryotherapy, PEMF, mild hyperbaric oxygen, and vibroacoustic stimulation. I’ve had the chance to ask questions, understand the intended effects and possible discomforts, and I am choosing to participate voluntarily.

3. Acknowledgement and Assumption of Risks: I understand that although the services offered by the Service Provider are non-invasive and designed to support physical and mental wellness, they are not without risks. By choosing to participate, I voluntarily accept all risks involved, whether known or unknown, foreseeable or not. These may include injury, illness, aggravation of a pre-existing condition, allergic or unexpected reactions, property damage, or in rare cases, disability or death. I understand that

each service comes with its own specific risks, such as photosensitivity, epileptic reactions, and pregnancy-related concerns with the Red-Light Chamber; fainting, falls, and cardiovascular strain with the Cryo

Chamber; heat intolerance and heart-related issues with the Far-Infrared PEMF Sauna; pressure-related discomfort or respiratory difficulties in the Mild-Hyperbaric Chamber; and circulatory issues or overstimulation when using the Vibroacoustic Lounger. I also understand that there may be additional risks not yet known or disclosed, and I still choose to proceed. I accept full responsibility for participating, agree to listen to my body, and understand that I can stop at any time.

4. Contraindications:

I understand that certain medical conditions - such as heart or respiratory issues, blood pressure problems, epilepsy, skin sensitivity, cold allergies, circulatory disorders like DVT, and pregnancy- may make it unsafe to use these services. I agree to inform the staff of any such conditions and accept full responsibility if I choose to proceed without disclosing them.

5. Non-Medical Services Disclaimer:

I understand that the services are not medical treatments and are not

meant to diagnose, treat, or cure any condition. The staff are not medical professionals, and the services are for general wellness only. I agree not to rely on them as a substitute for medical advice and will consult my doctor if I have health concerns.

6. Medical Emergency Authorization:

In the event of a medical emergency, I authorize the Service Provider

to seek emergency medical assistance on my behalf if deemed necessary. I acknowledge that I am solely responsible for any medical costs, treatment decisions, or outcomes, and I waive any claims against the Service Provider related to such emergencies.

7. Client’s Responsibilities:

I agree to follow staff instructions and use equipment as directed. I will inform the staff of any discomfort or health concerns and will not use the services under the influence of drugs or alcohol. I accept full responsibility for my actions and understand that ignoring safety guidance is at my own risk.

8. No Guarantees:

I understand that the Service Provider does not guarantee any specific results from its services. Outcomes may vary for each person, and no promises have been made regarding improvements to my health or well-being. I am participating based on my own judgment.

9. Limitation of Liability, Waiver of Claims, and Release:

In consideration for participating in the services

provided by the Service Provider, I agree to release, waive, discharge, and covenant not to sue the Service Provider, their owner(s), employees, agents, successors, and assigns (“Release Parties”), from any and all claims, demands, causes of action, damages, or liability that may arise from my participation in the services or my presence on the premises. This includes, but is not limited to, any injury, illness, disability, death, or property damage that may occur during or as a result of my use of the services, whether caused by negligence or otherwise. I further agree that neither I nor my heirs, assigns, legal representatives, or anyone acting on my behalf will bring any claim or lawsuit against Service Provider related to any such injury, loss, or damage. I understand that this waiver does not apply to any claim resulting from gross negligence or intentional misconduct.

10. Indemnification:

I agree to defend, indemnify, and hold harmless the Released Parties from and against any and all claims, demands, actions, liabilities, damages, losses, costs, or expenses (including reasonable legal fees) arising out of or related to my participation in the services, my presence on the premises, or any breach of this Waiver by me. This includes any claims brought by third parties as a result of my conduct, use of equipment, or failure to follow instructions.

11. Entire Agreement and Modification:

This Waiver constitutes the entire agreement between me and Service Provider regarding the services being provided, replacing any prior discussions or agreements. I acknowledge that no other promises or assurances have been made beyond what is stated here. Any

modifications to this Waiver must be in writing and agreed upon by both parties to be valid.

12. Severability:

If any part of this Waiver is found to be invalid, unenforceable, or illegal by a court of law, the rest of the Waiver will remain valid and continue in full force and effect. The invalid or unenforceable portion shall be interpreted or modified to the minimum extent necessary to make it valid while preserving the original intent of this Waiver.

13. Right to Refuse Service:

I understand that the Service Provider may refuse service at its discretion if my behavior, health condition, or failure to follow instructions poses a risk to myself, others, or the facility.

14. Governing Law and Exclusive Jurisdiction: This Waiver shall be governed by the laws of State of Florida (USA). Any disputes shall first be resolved amicably. If no resolution is reached, the matter shall

be submitted exclusively to the courts of Miami-Dade County, Florida.

15. Binding: This Waiver is binding on me, my heirs, executors, administrators, legal representatives, and anyone else who may claim on my behalf. It also extends to and benefits the Service Provider, including

their successors and assigns.

16. Acknowledgement:

I acknowledge that I have carefully read this Waiver in its entirety, fully understand its contents, and am aware that by accepting/signing it, I am voluntarily giving up certain legal rights, including my right to sue the Service Provider and other Released Parties. I confirm that I have had the opportunity to ask questions about this Waiver and have either received satisfactory answers or have chosen to proceed without seeking further clarification. I understand that if I do not fully comprehend any part of this Waiver, I should consult an attorney before accepting/signing it. I am signing this Waiver voluntarily, without any force, coercion, undue influence, or reliance on statements outside of what is stated in this document

SIGNATURE

Date
Jour
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Année
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