VIKING SUNSHINE MASSAGE RELEASE FORM 2023
Body Rebalancing Deep Tissue Fascia Massage

All clients visiting Viking Sunshine are required to agree to the following Release and Liability Waiver which is effective for all visits.

Sign in to Google to save your progress. Learn more
Full Name *
Address *
Email *
Contact Number *
Date of Birth *
MM
/
DD
/
YYYY
Height *
Weight *
ID / Passport Number *
Any Medical Conditions / Injuries - (This includes recent and old injuries) *
Do you currently have physical/specific body areas that need addressing in the session? *
Are you currently suffering from pain or stiffness? Please specify details. *
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