Check-In Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.First Name *Last Name *Alcohol & Drugs: I am not under the influence of alcohol, recreational drugs, or any medication or substance that could impair my ability to safely participate in today's services. *AgreeDyed Hair: I have not dyed, bleached, toned, or chemically treated my hair within the last 14 days (up to 30 days for vibrant colors). I understand that hair dye can permanently damage float tanks and that I may be responsible for up to $2,000 in damages if my hair causes contamination. *AgreeArtificial Tan: I have not used any spray tan or self-tanning products within the last 5 days. I understand that these products can damage float tanks and that I may be responsible for up to $2,000 in damages if contamination occurs. *AgreeTattoos & Piercings: I understand that newly received tattoos and piercings should be fully healed before participating in today's services. If I have received a tattoo or piercing within the last 4–6 weeks, I have discussed it with staff before my session. *AgreeAre there any changes or updates to your medical history that we should be aware of? *YesNoPlease describeAre any minors (under 18) accompanying you today and participating in services? *YesNoMinor Participant AuthorizationBy completing this section, you confirm you are the parent/legal guardian and you are signing this waiver on the minor’s behalf. Please list each minors information below. piercing can I Minor's Full Name *Date of Birth *Relationship to Minor *--- Select Choice ---ParentGuardianSiblingAunt / UncleGrandparentCousinLegal GuardianFoster ParentOtherMinor's Full NameDate of BirthRelationship to Minor--- Select Choice ---ParentGuardianSiblingAunt / UncleGrandparentCousinLegal GuardianFoster ParentOtherMinor's Full NameDate of BirthRelationship to Minor--- Select Choice ---ParentGuardianSiblingAunt / UncleGrandparentCousinLegal GuardianFoster ParentOtherMinor's Full NameDate of BirthRelationship to Minor--- Select Choice ---ParentGuardianSiblingAunt / UncleGrandparentCousinLegal GuardianFoster ParentOtherBy submitting this form, I certify that I am the parent or legal guardian of the minor(s) listed above and that they are participating under my supervision. I give permission for the minor(s) to participate in Salt Spa Wellness services and I acknowledge that this waiver, including the assumption of risks and release of liability, applies to me and to the minor(s) to the fullest extent permitted by Maine law.I agree to receive appointment-related text messages from Salt Spa Wellness, including confirmations, reminders, and last-minute availability. Message frequency varies. Reply STOP to opt out, HELP for help.Signature * Clear Signature Todays Date * Submit
