massage waiver | lakeview

Massage Liability Waiver

First Name

Last Name

DOB

Mobile Phone

Please specify any medical concerns we should know about, including if you've recently had surgery or will be pregnant at the time of the massage

Initials

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of this bodywork. I hereby assume all risks connected therewith and consent to this massage. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to the massage therapist prior to my service.

I understand this is for one massage for one guest and a couple's massage is not available. If I do not cancel my appointment at least 24 hours prior, I will be charged an additional $35 cancellation fee.

Please fill out a separate waiver for each person