Modrn Sanctuary Consent, Release of Liability and Waiver

This is an important legal document. It explains the risks you are assuming. It is critical that you read and understand it completely before you sign below.

I, the undersigned individual, acknowledge that by signing this Consent, Release of Liability and Waiver I am confirming that I recognize that there may be inherent risks associated with using Modrn Sanctury equipment and/or facilities, being exposed to infrared rays, and participating in and/or receiving sauna sessions and/or treatments at/in the Modrn Sanctuary facility (hereinafter “Services”), and that I understand that I am voluntarily assuming full responsibility for all such risks.

I acknowledge that the participation in/receipt of the Infrared services does not constitute the provision of medical or health care services and I acknowledge and agree that I am responsible for my own health and that Modrn Sanctuary cannot be expected to diagnose and/or treat individual health problems.

I understand that I am responsible for discussing any questions or concerns that I may have concerning my health conditions (if any), or concerning the Services in any way, prior to and throughout the Services with a Modrn Sanctuary associate.  Should I experience any pain or discomfort during the Services, or should any health-related symptoms occur, I will immediately cease my participation in the Services and inform a Modrn Sanctuary associate, of any such symptoms, and I will seek immediate medical attention from a doctor of my own choosing.

In the event that I have reason to believe that medical clearance must be obtained prior to participation in/receipt of any of the Services, I agree to first consult a physician and obtain written permission from a physician prior to the commencement of any Services.  I understand that Modrn Sanctuary will not inquire whether I require such medical clearance.

By voluntarily choosing to participate in/receive the Services, I warrant that to the best of my knowledge I am not pregnant and I do not have any disability, impairment, ailment or other condition that may prevent me from participating in/receiving such Services. I affirm that I have stated all my known medical conditions, and answered all questions honestly.

I hereby confirm that no warranty or guaranty or other assurance has been made to me regarding the results of the infrared sauna process or program, or any of the Services.

I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during the Services, but I acknowledge that Modrn Sanctuary has no duty to provide medical treatment to me.

Consequently, in light of the foregoing and in consideration for participating in/receiving the Services, I hereby, on behalf of myself and my heirs, beneficiaries, next of kin and assigns, forever waive, irrevocably release, discharge, and agree to indemnify, defend and hold harmless (i) Modrn Sanctuary, which is a DBA for Theta Spring Hypnosis LLC (and its parent corporation(s), subsidiaries, affiliated corporations); and (ii) each of their respective officers, directors, shareholders, employees, agents, representatives and successors, and forever waive and discharge in advance any and all claims, liabilities, or damages for personal injuries, demands, causes of action (including, without limitation, negligence) or any other claims of any nature whatsoever, including, without limitation, any losses for property damage, personal injury or death, that I may experience directly or indirectly from participating in/receiving any of the Services. It is my express intent that this Consent, Release of Liability and Waiver shall bind the members of my family, my personal representatives, heirs, beneficiaries and next of kin and my and their assigns, and shall be effective to the greatest extent permitted in accordance with the laws of the State of New York.

This Consent, Release of Liability and Waiver shall be effective for as long as I participate in/receive the Services and use the facilities at this location now and in the future, including participation in other programs offered by Modrn Sanctuary.

I represent and acknowledge that I have read and understand this Consent, Release of Liability and Waiver and understand that my voluntary execution evidences my agreement to the terms, provisions, waivers, and releases as set forth above. I acknowledge that I have had an opportunity to review this Consent, Release of Liability and Waiver with advisors of my choosing prior to participation in/receipt of any of the Services.  The invalidity, in whole or in part, of any portion of the above paragraphs will not affect the remainder of this form.