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ReThink Relax Waiver
First name
Last name
Email
Date of Birth
Do you have any medical conditions that prohibit a chair massage?
*
No
Yes
Please specify anything we should know about
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I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in an onsite chair massage. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.
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