BioMune Integrative Wellness Waiver
This is a release and indemnification waiver for all treatments and services offered at BioMune Integrative Wellness.  
DISCLAIMER: The treatments provided in our clinics should not be used in replacement for treatments advised/prescribed by your licensed physician. Always seek advice from your licensed physician and do not delay receiving medical treatment. In the case of a medical emergency, call 911.
Sign in to Google to save your progress. Learn more
Email *
Disclaimers About Services & Waiver

DISCLAIMER: This waiver is signed only one time for all current and future treatments, services, products, activities, and or therapies. The client need to update us by email with any changes in their health history as per any changes. When a client chooses to use our treatments ongoing or in the future; it is a client's responsibility to update this document. 

WAIVER AND RELEASE OF LIABILITY
In consideration of the risk of injury while participating in (the quote “Activity” or know as therapies or any inhouse treatments under Unit 7-19567, 64 Ave Surrey BC location),  I am voluntarily entering information and release of liability and hereby waive any claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and discharge against Biomune Integrative Wellness.

The risks may include, but are not limited to, those caused by facilities, temperature, weather, lack of hydration, condition of participants, equipment, and actions of others, including but not limited to, participants, volunteers, spectators, coaches, practitioners, owners, or staff.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. 

I have read and understand the terms and disclaimers attached to this waiver. *
Required
Full Name, First & Last *
Phone Number *
Full Name Parent/guardian (if applicable)
Birthdate *
MM
/
DD
/
YYYY
Gender (Sex) *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy