AUSTIN BODY COLLECTIVE, LLC
RELEASE & WAIVER OF LIABILITY
RELEASE & WAIVER OF LIABILITY. Austin Body Collective, LLC, doing business as Body Collective (“Body Collective”) offers yoga classes, dance classes, massage, acupuncture, and various other disciplines, training, and instructional activities (the “Activities”). In consideration for my participation in the Activities, I understand, acknowledge, and hereby agree to the following:
I understand that the Activities are potentially strenuous and hazardous activities that may present risk of injury, including serious disability or death. I recognize that participation in these Activities may require physical exertion, and I am fully aware of the risks and hazards involved.
I understand that the use of exercise equipment carries a risk of injury, including disability and death. While rules and techniques may minimize the risk of such injury, I understand that serious risk remains, and I am knowingly and voluntarily assuming full and sole responsibility for all risks, injuries, and damages that I may incur.
I understand that the Activities offered by Body Collective are not a substitute for medical or psychological treatment. I understand that Body Collective staff are not physicians nor licensed mental health providers. I understand and acknowledge that it is my responsibility to consult a physician prior to and regarding my participation in the Activities. I represent and warrant that I am suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation in the Activities or the use of any equipment at Body Collective. I agree to fully inform Body Collective of any condition that may limit my participation in the Activities and to promptly notify Body Collective of any material change to my health or physical condition, including pregnancy.
I understand and accept that my participation in the Activities may involve physical contact between Body Collective staff and myself. I consent to such contact and recognize that any such physical contact will be applied in a professional manner. I agree to inform Body Collective of any types of contact to which I do not consent before or as soon as they arise.
My participation in the Activities is completely voluntary. I assume full and sole responsibility for my health and safety and for all risks, injuries, or damages that I may incur participating in the Activities.
I understand that if I am attending a class or event at a third party’s location, Body Collective is not responsible or liable for any damage or injury to myself, my property or damage I cause to the third party’s property whether accidental, negligent or intentional.
I understand that my massage therapy sessions will consist of only therapeutic massage techniques. Draping will be used at all times; neither my breasts (if I identify as female) nor genital areas will be massaged. If I am uncomfortable for any reason, I will request to end the session and the session will be ended. I understand the risks of massage therapy, including but not limited to superficial bruising, soreness, and exacerbation of undiscovered injuries. I release Body Collective and the massage therapist of all liability in the event of such injuries. If under the age of 18, I must be accompanied by a parent or guardian during the entire session.
I understand that acupuncture methods of treatment include, but are not limited to: acupuncture, moxibustion, cupping, guasha, electro-acupuncture, tuina (Chinese manual therapy), herbal medicine, exercise and/or nutritional and lifestyle counseling and coaching. I understand that acupuncture is a generally safe method of treatment that involves the insertion of subcutaneous needles at various points on the body. I acknowledge that acupuncture may occasionally have some side effects including bruising, numbness, tingling or pain near the needle site that may last a few days, as well as dizziness or fainting. Burns and/or scarring are a potential risk of moxibustion and cupping, or when treatment involves the use of heat lamps or hot packs. Unusual risks of acupuncture include spontaneous miscarriage, nerve damage and organ puncture, including lung puncture (pneumothorax). Infection is another possible risk, although the practitioner uses sterile disposable needles and maintains a clean and safe environment. I understand that Asian manual therapy (including all bodywork procedures, cupping, guasha and qigong therapy/energy work) could constitute a wide range of manually applied techniques that could include, but are not limited to, light touch, deep pressure, and joint mobilization through stretching and passive range of motion. I understand that any or all aspects of Asian manual therapy may result in fatigue, nausea, malaise, soreness, bruising and aching for multiple days after treatment and that bruising is a common side effect of cupping and guasha. Emotional release and regression to past traumatic events may also result from any or all aspects of treatment. My acupuncture practitioner may recommend the consumption of certain herbs, but I understand that my consumption of such herbs is completely voluntary. The herbs may have an unpleasant smell or taste. The herbs and nutritional supplements (which are from plant, animal, and mineral sources) that I have been recommended are traditionally considered safe in the practice of Chinese Medicine, although some may be toxic in large doses. Some possible side effects of taking herbs are nausea, gas, stomachache, vomiting, headache, diarrhea, rashes, hives, and tingling of the tongue. I will immediately notify my practitioner if I experience any of these side effects or any other unanticipated or unpleasant effects associated with the treatment and/or consumption of herbs. I understand that some herbs and other treatment methods may be inappropriate during pregnancy. I will notify my practitioner if I am now or become pregnant. I understand that while this document describes the major risks of treatment, other side effects and risks may occur. As with any medical or health-related treatment, I understand that it is impossible to accurately predict how any one person may respond to treatment and I acknowledge that, in extreme and very rare circumstances, adverse side effects may even result in blindness, disability and/or death. I understand that acupuncture and Chinese medicine treatment is not a replacement for diagnostic medical procedures. I understand that an acupuncturist does not diagnose according to standard medical practice, nor should a “Chinese Diagnosis” be considered a replacement for standard medical evaluation or testing. I acknowledge that my practitioner is not a Primary Care Doctor, Medical Doctor, Naturopathic Doctor, Doctor of Osteopath, Doctor of Chiropractic, nor a Doctor of Physical Therapy and does not claim to practice within the scope thereof.
I understand that by participating in yoga classes offered at Body Collective, I may receive information and instruction about yoga and Ayurveda including but not limited to physical exercise, meditation, breathing techniques, and herbal remedies. I recognize that yoga instructors contracted to work at Body Collective are not licensed physicians nor mental health professionals. Yoga instruction is not licensed by the state of Texas and is an alternative or complementary treatment to the healing arts services licensed by the State.
While there can be many benefits to my participation in the Activities, I understand and acknowledge that Body Collective makes no warranty or guarantee, whether express or implied, as to any specific outcome or result.
ON BEHALF OF MYSELF, MY HEIRS, AND LEGAL REPRESENTATIVES, I HEREBY KNOWINGLY, VOLUNTARILY, AND EXPRESSLY WAIVE, RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY, DEFEND, AND HOLD HARMLESS BODY COLLECTIVE AND ITS OFFICERS, AGENTS, EMPLOYEES, CONTRACT EMPLOYEES, REPRESENTATIVES, AND ALL OTHER PERSONS OR ENTITIES ACTING ON BEHALF OF BODY COLLECTIVE FROM AND AGAINST ANY AND ALL CLAIMS, LIABILITIES, DAMAGES, LOSSES, DEMANDS, CAUSES OF ACTION, AND COSTS AND EXPENSES, INCLUDING BUT NOT LIMITED TO ATTORNEYS’ FEES AND COURT COSTS, WHETHER KNOWN OR UNKNOWN, DIRECTLY OR INDIRECTLY ARISING OUT OF OR RELATING TO MY PARTICIPATION IN THE ACTIVITIES, INCLUDING BUT NOT LIMITED TO CLAIMS OF PHYSICAL OR PSYCHOLOGICAL ILLNESS OR INJURY, BODILY HARM, MEDICAL EXPENSES, DEATH, DAMAGE TO PROPERTY, AND LOSS OR THEFT OF PERSONAL PROPERTY, REGARDLESS OF WHETHER SUCH CLAIMS ARISE IN WHOLE OR IN PART FROM THE ACTS, OMISSIONS, OR NEGLIGENCE OF THE PARTIES.
This agreement shall be governed by the laws of the State of Texas. To the extent any provision of this Agreement is held unlawful, void, or for any reason unenforceable, such provision shall be deemed severable from this document and shall not affect the validity or enforceability of the remaining provisions.
I hereby certify that I am the parent or guardian of a minor child under the age of eighteen years, and I consent to his/her participation in the activities set forth in this Waiver.
I HAVE READ AND UNDERSTAND THE ENTIRE ABOVE AGREEMENT, AND I AM SIGNING IT FREELY AND VOLUNTARILY. I AFFIRM THAT I AM AT LEAST 18 YEARS OLD.