Thank you for choosing Organic Lavender Day Spa,Inc., DBA Pure Lavender Day Spa:

Please take a moment to read and check the following information before your massage therapy session:

I, hereby acknowledge that I am voluntarily receiving massage services and/or other bodywork or treatment (the "Services") from Pure Lavender Day Spa, at my own risk. I understand that my health and safety with respect to such services are my sole responsibility.

Risks

I have been informed of the potential risks associated with receiving massage therapy and/or other bodywork or treatment, including but not limited to: soreness, muscle damage, dizziness, mental/emotional discomfort (anxiety), and skin irritation.

I understand that these risks may arise from the services provided by Pure Lavender Day Spa, and I assume all responsibility for any potential harm or injury.

Release of Liability

In exchange for receiving Services from Pure Lavender Day Spa , I, for myself and on behalf of my heirs, executors, administrators and personal representatives, hereby waive, release, discharge and hold harmless Pure Lavender Day Spa its members, officers, employees and agents from any and all liability for any injuries, including death, damages or claims relating to or resulting from my receipt of the Services.

Furthermore, I agree to indemnify and hold Pure Lavender Day Spa, its members, officers, agents and employees, harmless from any and all claims, rights, damages, liabilities, losses, costs and expenses (including reasonable attorneys’ fees) arising from or in connection with any injuries to other persons or damage to property caused by or attributed to me.

Purpose of Services

I understand that massage therapy and other bodywork or treatment are provided for stress reduction, relaxation, relief from muscular tension, and improvement of circulation and energy flow.

Communication

During the session, if I experience any pain or discomfort, I will immediately inform my therapist so that pressure/strokes can be adjusted to my level of comfort. I also acknowledge that my therapist is not responsible for any pain or discomfort I may experience during or after the session.

Medical Disclaimer

I understand that the services offered today are not a substitute for medical care. My therapist is not qualified to perform spinal or skeletal adjustments, diagnose, prescribe, or treat physical or mental illness. By signing this release, I affirm that I have notified my therapist of all known medical conditions and injuries, and I agree to inform my therapist of any changes in my health and medical condition. I also understand that there shall be no liability on the therapist’s part if I forget to do so.

No Sexual Activity

I understand that all services provided by Pure Lavender Day Spa are entirely therapeutic and non-sexual in nature.

Any inappropriate behavior or requests will not be tolerated.

Agreement By completing this Massage Client Waiver Form, I hereby waive and release my therapist from any and all liability, both past and future, pertaining to body massage. I acknowledge receipt of the policy statement and confirm my understanding and agreement to the policies outlined therein. I affirm that the information provided below signifies my consent to receive Services from Pure Lavender Day Spa, and I certify that all provided information is accurate to the best of my knowledge.