Improve your work efficiency with electronic medical release waivers.
MIZU INTEGRATIVE MEDICINE CLINIC LLC
5161 San Felipe Suite 120
Houston, TX 77056
Liability Waiver
In exchange for permission to use the facilities and services of MIZU Integrative Medicine Clinic, LLC d/b/a MIZU (“MIZU Integrative Medicine Clinic + Float Center”), I agree and represent as follows:
I am voluntarily floating with full knowledge and awareness of the risks therein, including without limitation wet and potential slippery areas within the floating pods, and agree to assume all risks associated therewith. I am of sound condition to float. I will not use MIZU's facilities while under the influence of alcohol or other substances, legal or otherwise, which would impair my judgment. I will only float face up, and acknowledge that I may exit the float tank at any time. In the event that I require assistance, I authorize MIZU's personnel to enter my float suite or float pod for the purpose of rendering help; provided however, that it is my full responsibility to arrange for assistance if I shall require it in order to float. If I am physically unable to float by myself, I will refrain from floating activities at MIZU’s facilities, unless I have arranged for someone qualified or physically able to assist me and who will remain with me in my pod suite throughout the floating activity (which shall not obligate any MIZU staff to assist me in any way). I acknowledge that MIZU is not responsible for damages to or loss of jewelry, watches, phones, or any other personal items.
I acknowledge that if I have a mental illness, claustrophobia, or any condition that may adversely affect my experience, or be adversely affected by floatation, that I have consulted or will consult with a professional prior to floating, and have taken or will take all necessary precautions in order to ensure a safe experience. I further represent that I have not been instructed by any professional not to use MIZU's facilities, and that I will not use MIZU's facilities if so advised by a professional. I acknowledge that I do not have any medical conditions or otherwise that that may adversely affect the quality of the water of the tank. I further acknowledge that I do not currently have any conditions such seizure disorder, pregnancy, open or healing wounds, skin lesions, bleeding, infections, nausea, vomiting or incontinence.
I acknowledge that MIZU has made no claims as to health or medical results, which I can or may be able to obtain through the use of MIZU's facilities. MIZU has neither suggested to me, nor will it, any medical treatments or diagnoses.
I, and all of my heirs, successors, assigns, and agents hereby completely and irrevocably release and forever discharge MIZU, and its members, officers, directors,
employees, agents, predecessors, successors, and assigns, with respect to any and all known or unknown claims, demands, actions, and causes of action, suits, debts, liabilities, orders, decrees, obligations, judgments, and damages whatsoever, whether suspected or unsuspected, vested or contingent, in law or in equity, existing by statute, common law, contract, or otherwise which have existed, do exist or may exist, in any way relating to any and all injuries and damages of any and every kind, to person or property, arising out of the use of the facilities, equipment and services. I acknowledge that MIZU, and its members, officers, directors, employees, agents, predecessors, successors, and assigns shall not be liable for any loss, loss of property, damage, injury, accident and/or death which I may suffer. I agree to indemnify and hold harmless MIZU from any and all claims, suits, actions or proceedings of any kind arising out of, or in connection with, the use of the facilities, equipment and services. This will be binding upon my heirs, successors, assigns and legal representatives. If any portion of this release from liability shall be deemed to be invalid by a court of competent jurisdiction, then the remainder of the release shall remain in full force and effect.
I acknowledge that I am responsible for any property damage, equipment damage, or tank contamination that I may cause.
I acknowledge that I am at least 18 years of age.
I ACKNOWLEDGE READING A COMPLETED COPY OF THIS AGREEMENT BEFORE AFFIRMATIVELY CONSENTING TO BEING LEGALLY BOUND BY ITS TERMS.
I ACKNOWLEDGE THAT THIS WAIVER AND RELEASE OF LIABILITY SHALL APPLY TO ALL VISITS AND USES OF MIZU’s FACILITIES WITHOUT THE REQUIREMENT TO EXECUTE OR ACKNOWLEDGE A WAIVER AND RELEASE UPON EACH VISIT.
