Please read carefully before signing.
In consideration of the undersigned individual (“I” or “me”)
being permitted by Jarin Wadiwalla of The OMbak Way (“Company”) to
receive tuning fork, sound therapy and related services (the
“Therapy”), I agree as follows:
1. I acknowledge and agree that (i) I am physically able to
engage in the Therapy, (ii) I have no known conditions that would restrict me
from participating in the Therapy, and (iii) my doctor has not restricted me
from engaging in the Therapy.
2. I confirm that I will follow all instructions,
recommendations, and cautions of the Company at all times while on the
Company’s premises or during the Therapy. If at any time I believe
conditions to be unsafe or I am no longer in proper physical condition to
participate in the Therapy, I will immediately discontinue further
participation in the Therapy.
3. I am aware and understand that a risk of injury is present
whenever I participate in the Therapy, which may result in illness, personal
or psychological injury, pain, suffering, temporary or permanent disability,
death, and/or financial loss. I acknowledge that these risks may result from
or be compounded by the actions, omissions, or negligence of Company
employees or others, including negligent emergency response or rescue
operations of the Company. I understand that while the Company has
implemented measures to reduce the risk of injury from the Therapy, the
Company cannot guarantee that I will not be injured while on the
Company’s premises or during my participation in the Therapy.
I HEREBY AGREE TO ACCEPT AND ASSUME ALL RISKS ARISING FROM THE
THERAPY, WHETHER CAUSED BY THE ORDINARY NEGLIGENCE OF THE COMPANY OR
OTHERWISE.
4. I hereby expressly waive and release any and all claims,
now known or hereafter known, against the Company and its members, officers,
managers, employees, agents, successors, and assigns (collectively,
“Releasees”) on account of personal or psychological injury,
illness, pain, suffering, temporary or permanent disability, death, or
financial loss arising out of or attributable to my being on the
Company’s premises or participating in the Therapy, whether arising out
of the ordinary negligence of the Company or any Releasees or otherwise.
Typing your full legal name above constitutes your electronic signature and
has the same legal effect as a handwritten signature.