Salt Spa Wellness Intake Waiver and Consent for Minors

Salt Spa Wellness Waiver and Consent for Minors (Under 18)

Welcome to Salt Spa Wellness – We’re So Glad You’re Here
Thank you for taking a moment to complete this form prior to your appointment. If you are under the age of 18 a parent / guardian will need to complete this with you. The questions below help us tailor your experience and keep you safe during your visit. To keep things simple, we’ve included all of our services in one form – no need to fill out a separate intake for each modality. Even if you’re only planning to use one or two services, having everything in one place allows us to better serve you and keep your wellness journey as smooth as possible.
We appreciate your time and look forward to helping you relax and recharge. Please note, we do require this form be updated yearly.

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Do you understand that they can't float if they have dyed their hair in the last 14 days? (up to a month if a vibrant color) (Please note there is a $2,000 fine for bleeding hair dye which will damage our tanks)

Do you understand that they can't float if they used any spray tan or self tanners in the last 5 days? (Please note there is a $2,000 fine for dye damage to the tanks)

Do you understand that we do not recommend floating if they have gotten a tattoo or piercing in the last 4-6 weeks? (We highly recommend these be fully healed before participating in any of our services.)

I last note

This Release and Waiver of Liability ("Agreement") is entered into between Salt Spa Wellness (the "Company") and the undersigned guardian of the client (the "Client") who desires to engage in services offered by the Company. This Agreement is intended to release and discharge the Company from any and all liability for personal injuries, property damage, or other claims that may arise from participation in services provided at Salt Spa Wellness.

FLOAT THERAPY

I understand that float therapy involves floating in a high-concentration Epsom salt solution.
I understand they may experience skin sensitivity or tingling sensations, especially if I have recently shaved.
They will not float if I have had recent hair dye that bleeds, spray tans, or any contagious conditions such as open wounds or infections.
I understand there is a risk of slipping on wet surfaces and agree they will use caution.
I acknowledge that any contamination of the float tank may result in a cleaning and salt replacement fee of up to $2,000.
They are not under the influence of drugs or alcohol and will follow all hygiene and safety protocols.

INFRARED SAUNA AND RED LIGHT THERAPY

I acknowledge that infrared sauna and red light therapy may elevate their body temperature and carry risks such as dehydration, dizziness, or overheating.
They do not have any conditions (e.g., cardiovascular issues, heat sensitivity, metal or silicone implants) that would make sauna use unsafe unless cleared by a medical provider.
I will consult their doctor regarding any medications I am taking that may affect my body’s response to heat (e.g., diuretics, beta-blockers, antihistamines).
I understand that children are more sensitive to heat and that pediatrician consultation is recommended before use.

SALT THERAPY (HALOTHERAPY)

I understand that salt therapy involves breathing in dry salt aerosol particles, which is not a substitute for medical treatment.
They may experience temporary side effects such as coughing, dry throat, or nasal drip as my respiratory system clears.
I will inform the staff if they experience shortness of breath or skin irritation.
They do not have any contraindicated conditions such as tuberculosis, contagious disease, cancer, fever, or other respiratory complications.
I understand this therapy is not a cure and is not FDA-approved.

AQUA MASSAGE

I understand that Aqua Massage uses heated, pressurized water jets through a protective barrier.
The massage may cause discomfort if they have conditions such as circulatory issues, varicose veins, infections, or inflammation.
I will consult their physician if they have any conditions where heat or massage may be harmful.
They will exercise caution when entering or exiting the equipment to prevent dizziness or falls.

GENERAL TERMS APPLICABLE TO ALL MODALITIES

I understand that the services provided are not intended to diagnose, treat, cure, or prevent any disease.
I acknowledge that they am voluntarily participating in these services and assume full responsibility for any injury or loss that may result.
They agree to follow all instructions, guidelines, and safety procedures provided by the Company and its staff.
I understand that failure to disclose relevant health information may increase the risk of injury.

I HEREBY EXPRESSLY WAIVE AND RELEASE ANY AND ALL CLAIMS, NOW KNOWN OR HEREAFTER KNOWN, IN ANY JURISDICTION AGAINST SALT SPA WELLNESS, AND ITS OFFICERS, EMPLOYEES, AGENTS, HEIRS, AND AFFILIATES (COLLECTIVELY, "RELEASEES"), ARISING OUT OF OR ATTRIBUTABLE TO THE MINORS PARTICIPATION IN THE SERVICES, WHETHER ARISING OUT OF THE NEGLIGENCE OF THE COMPANY OR OTHERWISE. I COVENANT NOT TO MAKE OR BRING ANY SUCH CLAIM AGAINST THE COMPANY OR ANY OTHER RELEASEE.

MAINE GOVERNING LAW CLAUSE

This Agreement shall be governed by, and construed in accordance with, the laws of the State of Maine, without regard to its conflict of laws principles. Any disputes arising under or in connection with this Agreement shall be subject to the exclusive jurisdiction of the courts located in the State of Maine.

REFUNDS

All sales are final; refunds are not provided for any reason.
A valid service purchase is required to reserve an appointment. This payment holds your reservation and will not be refunded in the event of cancellation or no-show.
You are welcome to reschedule your appointment in accordance with our rescheduling policy.
Any purchased services will remain on your account as a service credit, which can be used or transferred to another user. Credits expire one year from the date of purchase.

RESCHEDULING & CANCELLATIONS

Rescheduling is permitted with a minimum of 24 hours’ notice. To reschedule your appointment please log in to your account or call our front desk at 207-910-5100.
If you need to cancel in advance, your prepaid service credit will remain on your account and may be used to reschedule at a future date. Refunds are not issued.
Late cancellations (less than 24 hours’ notice) or no-shows will be considered a cancellation and will result in a cancellation fee equal to the full cost of the service that was scheduled. If you have a float or service credit on your account, it will be applied as your cancellation fee.
We understand that life happens. If you’re unable to attend your appointment, you may send someone in your place to avoid the cancellation fee.

I am the parent or legal guardian of the minor named below. I give my permission for this minor to receive services at Salt Spa Wellness. I acknowledge that I have read and understood this waiver, including any risks associated with services such as float therapy, salt cave/salt room sessions, sauna, or aqua massage. I voluntarily accept and assume all risks associated with these services on behalf of the minor. I release and hold harmless Salt Spa Wellness, its staff, owners, and affiliates from any liability that may arise from the minor’s participation. I confirm that the minor is in good physical condition to receive these services and that I have disclosed any relevant medical conditions.

Parent / Guardian Signature

Clear Signature

Todays Date

Signature of Minor (if over 14 years old)

Clear Signature