Participant Agreement |
Health Risks & Liability |
Rights & A/V Waiver
Scope of Practice and Services |
Carefully read and understand, agree or otherwise acknowledge this release of liability and right waiver by participants (users of service) to affirm informed consent to massage and agree to release all applicable liability and rights mentioned in this agreement. I waive my legal right to bring a civil lawsuit against MTM for any damages I may sustain as a result of the wrongful conduct of MTM of which I knowingly and voluntarily assume the risk of any or all injury and agree not to sue. I waive all ownership rights or compensation for any image, video, and media of my person, likeness, or belongings obtained, distributed, or sold by Massage Therapy Matters.
I hereby, for myself, my heirs, executors, administrators, assigns, legal and personal representatives, knowingly indemnify and hold harmless Massage Therapy Matters, in accordance with this release of liability and rights waiver. I do voluntarily waive and expressly discharge any liability, rights, demands, causes of action, responsibility, and/or any claims or causes of action arising out of my person and any person related to MTM or against MTM. In regards to errors, omissions, acts or failures to act, or negligence regarding actions of Massage Therapy Matters hereby known as “services”, I waive my rights indefinitely to maintain full restraint covenant, to the greatest extent allowed by law in the state of Utah, against Massage Therapy Matters, known herein as"MTM”, or “Massage Message”, or “Massage-Yoga Retreat”, which refers to all encompassed entities, direct or indirect subsidiaries, affiliates, employees, contractors, officers, directors, attorneys, agents, representatives, therapists, managers, instructors, teachers, members, sponsors, volunteers, staff, and any other entity or person acting on behalf of Massage Therapy Matters, including any heirs, predecessors, successors, assigns, and those otherwise associated with or authorized by MTM. MTM may organize, lead, teach or otherwise provide massage therapy, stretching, wellness instruction, yoga, seminars, talks, competitions, challenges, and related activities at which, referred to throughout as “Services“, are independent of those provided by my company or owner of premises.
I, the participant, affirm that I am older than the age of 18 years, or have parental consent present with parental written name on applicable schedule, meaning my agreement is entered by my own free will, without duress or coercion and is to be interpreted as between the parties of equal bargaining strength. Both I, the participant, and MTM agree to clear and unambiguous terms, therefore no other evidence will be used or admitted to alter or explain the language or purposes for which I entered into; I assume complete responsibility for any damages or injury which may incur through participation. I knowingly accept the risk of damages or injury so I hereby release MTM from any liability now or in the future for damages or injury related to, including, but not limited to, heart attacks, strokes, fainting, muscle strains, pulls or tears, soft tissue damage, ligament or tendons, broken bones, shin splints, heat prostration, knee/lower back/foot/neck/general pain, idiopathic or known disorders, economic loss, emotional loss, any other illness, soreness, paralysis, swelling, bruising, serious physical or psychological changes, suffering, illness, mental crisis, disfigurement, temporary or permanent disability (including paralysis), economic loss, property loss, emotional loss, and death, however caused either occurring during or as arising outcomes, conditions related to travel, condition of the services, defects or damage of equipment, dangerous conditions on the premises, any handling of any image, video, and media of my person, likeness, or belongings, and any other willful or negligent acts of MTM. Modifications to this agreement are not binding unless approved by both parties in writing and cannot be modified orally.
Release of Liability and Rights
I am voluntarily participating in the massage entirely at my own risk. I am aware of the risks associated with this massage, which may include, but is not limited to, physical or psychological injury, pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis), economic or emotional loss, and death. I understand that these injuries or outcomes may arise from my own or others' negligence, conditions related to travel, or the condition of the massage. Nonetheless, I assume all related risks, both known or unknown to me, of my participation in this massage, including travel to, from and during this massage. I acknowledge that this massage may involve a test of a person's physical and mental limits and may carry with it the potential for dynamic homeostasis, death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of other participants, volunteers, spectators, officials and representatives of Massage Therapy Matters.
I am voluntarily wishing to experience a session(s) of therapeutic massage (or other modality). I understand that massage therapists do not diagnose illness, prescribe medications or make spinal adjustments. I further understand that massage is not a substitute for medical care or treatment. I have alerted my therapist to any conditions I have which may affect the work and have disclosed all medications (herbal or pharmaceutical) that I am currently taking. I further agree to update my practitioner to any changes in my mental, emotional or physical health.
I am seeking therapeutic massage of my own accord for the purposes that massage is intended. Such purposes include but are not limited to relaxation, mental wellness, relief of tension of sore muscles, improved circulation and/or improved range of motion.
I understand and have explained to me the procedure, benefits and contraindications for massage and the side-effects which may occur as a result of massage.
I will inform therapist if I fall into one of the two categories;
I am not working for or connected with any massage board, advisory board or licensing agency.
I do have an affiliation to a licensing agency, massage or advisory board; and I have listed my association below and the reason(s) I am seeking massage:
In consideration of the risk of injury while participating in therapeutic massage care ("massage”), and the right to participate in the massage, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver’s terms and release of liability and full waiver of all rights to any image, video, and media of my person. I hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the massage, and do hereby release and forever discharge Massage Therapy Matters. currently located at 8043 n ridge loop e apt j9, eagle mountain utah 84005, their affiliates, managers, members, agents, contractors, attorneys, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economic or emotional loss, that I may suffer as a direct result of my participation in the massage, including traveling to and from an event related to this massage. In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance due to MTM not holding any liability.
Cancellation Agreement: Bookings are times reserved solely for you, the participant. Be sure to act, or give notice to MTM more than 24 hours prior to the scheduled start for any cancellation or rescheduling. We understand that unanticipated events happen and have adopted this agreement to be effective, fair, and accommodate participants. The travel fee covers fuel and parking fees accrued by the therapist. We will do our best to satisfy your requests. ou, the participant, are responsible for the full session cost regardless of late arrival or no show. A session is not fully refundable if made less than 24 hours in advance. If the participant cancels more than 24 hours prior to the start, then charges are 100% refundable. Participant notice of cancellation given less than 24 hours prior to start incurs a 100% charge. If participants reschedule less than 24 hours prior to the start, then charges are 50% refundable. MTM must receive notice of membership cancellation in writing before your next billing date. Failure to send notification of cancellation before the next billing date will result in your account being charged. We do not issue refunds for failure to notify us before the required date.
Schedule Agreement: To ease the flow and track participants, we provide a scheduling link to share with participants. Use link to online self-sign up with LMT/YTs (licensed massage therapist/yoga teacher). Participants review the clickable link to agree to MTM | Release of Liability and Rights Waiver (http://docs.google.com/document/d/1U-uETGHWQ9xi2rpQk3hoe_kzi6YJ8UlzgmNfgkpKPn0/edit?usp=sharing) when participants place an "X" below next to their input first and last name to indicate agreement to the MTM waiver. In case the company has a separate consent or liability waiver for participants, please send it over to MTM at Message@MassageTherapyMatters.com.
Services Agreement: MTM is contracted for a scheduled start time and duration. Beyond said time frame, any extension of services beyond the contract with MTM, is therefore solely between LMT/YT, company, and participant. LMT/YTs are contracted and allowed by MTM to self-promote including self-marketing, session extension, and follow up appointments. Each session is allotted (designated F. above) minutes. This includes time for assessment and feedback. The session begins and ends at the scheduled time regardless of whether the participant is late. In order to maximize the massage benefits, participants will accurately fill out an intake form and updates as needed. Participants will communicate in an open, honest manner. Equipment brought (designated E. above) is subject to the following; Chair massage is quoted for hands-on massage time minus 3 minutes for disinfection and turnover in between participants. Table massage is quoted for hands-on massage time only, be sure the full hands-on session time is provided. 5-minute disinfection time is not included in the table massage quote. Hospice massage is quoted for hands-on massage time of up to 60 minutes, with ample time for infection control, disinfection, and sanitation prior to and following hands-on. We may compensate LMT/YT for onsite requests only to arrive for set up on time 20 minutes ahead of the hands-on to find free parking, locate the contact, set up supplies/ equipment, and begin a hands-on massage ahead of the requested appointment start time. LMT is a licensed massage therapist, aka masseuse (female) and masseur (male) utilize the manipulation of the muscles and other soft tissues of the body for therapeutic purposes. YT is a yoga teacher, aka instructors are fitness professionals who teach yoga, the low-impact exercise that uses controlled postures and breathing techniques to improve flexibility and strength. LMT/YT is here to compliment the experience via a therapeutic wellness service to increase awareness, mindfulness, community and can provide effective stress management. Any extension of the session or gratuity/ tips for exceptional service are solely between participant and LMT/YT. Refreshments supplied by the company are appreciated but not required. Personal and professional boundaries will be respected at all times. Inappropriate behavior by LMT/YT or participants is not tolerated. Sexual harassment will not be tolerated. If LMT/YT feels his/her safety is compromised, the service will be stopped immediately. Participants are responsible for her/his health and may end service at any time for any reason. Ensure participants shower before the massage for health, hygiene and relaxation benefits. Payment is due prior to the session unless prior arrangements have been made.
I acknowledge that Massage Therapy Matters and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or massage on behalf of Massage Therapy Matters. I agree to indemnify and hold harmless Massage Therapy Matters against any and all claims, suits or actions of any kind whatsoever for liability, civil rights, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs, including release for negligence, on the part of Massage Therapy Matters, its agents, and representatives, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Massage Therapy Matters incur any of these types of expenses, I agree to reimburse Massage Therapy Matters in full. In the event that any damage to equipment or facilities occurs as a result of my or my family's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any actions of neglect or recklessness.
I acknowledge that I have carefully read this waiver and release and fully understand that it is a release of liability and rights to any image, video, and media of my person.. I expressly agree to release and discharge massage therapy matters and all of its affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I otherwise have to bring a legal action against massage therapy matters for personal injury or property damage. This agreement was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between the two parties of equal bargaining strength. Both the participant, and Massage Therapy Matters agree that this agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.
I, the participant, affirm that I am older than the age of 18 years, or have parental consent present with parental written name, and that I am freely signing this agreement. I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a release of liability and release of rights to any image, video, and media of my person obtained by Massage Therapy Matters. This release agreement is a contract that I am entering into by writing my name of my own free will.