Please read the content below then scroll to the bottom of the waiver to sign

Safety Instructions and Contraindications for all Treatments

The following waiver, initialed areas and signatures constitute my representation, acknowledgement and agreement that I, , have read, understand, and fully agree to the following:

Hyperbaric Oxygen Therapy (HBT)

• If I am undergoing m-HBT for general health and wellness, then I understand that m-HBT is only FDA cleared for medically treating altitude sickness. If I do not have this condition then I am not using it to treat a medical condition, but only as an aid to help improve my physiological oxygen levels, with the goal of helping to improve my general well-being.

• HBT is only FDA cleared for: Decompression sickness, gas embolism, CO & cyanide poisoning, selected aerobic and anaerobic soft tissue infections, gas gangrene, osteomyelitis, intracranial abscess, management of fungal disease, radiation injury to tissue, exceptional blood loss/anemia, crush injury/compartment syndrome, ischemia reperfusion injuries, skin grafts and flaps, healing in selected problem wounds, and treatment of thermal burns.

• If I have a signed physician form/prescription from a doctor that believes that this will help my condition, I understand this is considered ‘off-label’ and not supported by the FDA (unless the condition is one of the FDA cleared indications). For this reason, the nature and purpose of hyperbaric oxygen therapy has been explained to me and I understand the explanation. Also, the consequences, risks, costs of treatments, and alternatives to m-HBT have been explained to me and I have also been informed that m-HBT may need to be repeated in the future, either by repeated sets of treatments or by frequent maintenance treatments in order to help maintain the benefits.

• I have been given the opportunity to ask any question I might have regarding m-HBT and/or OT (oxygen therapy), and the staff has answered my questions.

• I have informed the staff of my current health status, all current medications, and therapies, and I agree that it is my responsibility to keep the staff aware of any changes in my condition, medication, or therapies, for every session.

• I will follow the instructions of the hyperbaric chamber staff and I will inform the staff of any concerns during the treatment, such as pain, nausea, diarrhea, dizziness, visual changes, ringing or other noises in the ears, unusual smells, fear or anxiety reaction, unusual sweating, changes in heart rhythm, hiccups, chest pain, faintness, mood changes, difficulty breathing, or any discomfort.

• I have read and understand the FAQ and will comply with its instructions.
Potential Risks of m-HBT: Eardrum/sinus discomfort or pain, reversible myopia, confinement anxiety/claustrophobia, fatigue, collapsed lung/pneumothorax, severe lung diseases/lung damage from pressure, heart failure, blood sugars may drop in diabetics, cataract maturation.

• If any unforeseen conditions arise during the course of this treatment, I do hereby authorize/request the staff to perform such additional procedures and/or to render such treatments as may be deemed necessary at that time.

Softwave Therapy | Extracorporeal Shockwave Therapy (ESWT)

Shockwave Therapy, or Extracorporeal Shockwave Therapy (EWST), is a non-invasive treatment that involves the delivery of shock waves to an injured area to promote healing. This treatment produces highly effective shock waves that initiate biological regeneration processes at the cellular level.

Treatment involves technology that applies short, frequent, and high intensity bursts of mechanical energy (in the form of a shockwave) into soft-tissue that is injured, scarred, or contains adhesions, is painful, or inflamed.

RISKS OF THIS PROCEDURE
A)Pain and soreness. This is temporary and resolves after a few days.
B)The FDA has labeled this a “Non-Significant Risk” therapy.

I have been fully informed of ESWT, which the use of has been fully explained to me by my treating physician/staff, and I fully understand the nature of this treatment. I also confirm that I have been given the opportunity to discuss and clarify any concerns and that no guarantees have been made to me, mostly for pain relief and may offer an improvement of function. I also understand the foregoing treatment is not the first option for my condition and an alternate treatment has either been provided or offered to me.

THOR Laser/ NovoTHOR Bed Contraindications

Do not use Thor if you have or may have any of the following conditions: Pregnancy, epilepsy, known carcinoma, have any photosensitivity or on any photosensitizing drugs. If you have any other illness or medical condition, consult your physician prior to using Thor.

THOR LX2 Laser/NovoTHOR Bed Session Consent

I understand that Thor LX2 is a laser and the Novothor Bed is a light therapy modality, intended to stimulate healing and relieve pain.

The session should not be painful and you should feel no significant heat but you may feel a pleasant warmth.If uncomfortable for any reason the client or therapist may ask to end the session, and the session will be ended immediately.

Electrons+ PEMF

Electron Plus, Inc. is a guided PEMF (pulsed electromagnetic field) device that creates a powerful electromagnetic field that is guided from the practitioner into the patient. The Electrons Plus Guided PEMF Machine is considered experimental and has not been cleared by FDA. By signing below, you acknowledge this. I verify that I am not pregnant, I do not have a pacemaker, have had organ transplants, hearing aids, medical pumps or other electrical implants/devices. Pulsed electromagnetic fields (PEMF) support the natural elimination of toxins. While this elimination is beneficial, it is very important that you drink a sufficient amount of water to assist this process. I understand I may experience A Healing Reaction or Retracing. Healing reactions are temporary symptoms that occur as a result of the retracing healing process. You may experience mild symptoms of an old injury, detoxing reactions, mild nausea, headache, stiffness, body ache, or digestive disturbance. These symptoms will pass and are signs of healing.

Neubie

ACKNOWLEDGEMENT OF RISK: I understand that my session(s) at The Fix involve the use of the FDA-cleared Neubie® device in combination with various movements, exercises and/or techniques of manual therapy. The service providers at NeuFit have been trained in the safe and effective use of the Neubie and other techniques being used. Nevertheless, I acknowledge that there are inherent risks associated with these activities, including but not limited to the following:

•Use of the Neubie may lead to redness of the skin, or skin irritation like stinging or burning;

•Because the Neubie can create more load on muscles than is experienced in a typical workout, it often allows us to make more progress in a NeuFit session than in a traditional therapy or fitness session. For that same reason, using the Neubie may also lead to muscle soreness, fatigue, and a need for increased recovery time;

•That additional load on the muscles may also create more muscle breakdown than a typical workout. When the byproducts of muscle breakdown enter the bloodstream, the organs have to process them. If enough of these byproducts build up in the blood, especially when combined– with dehydration, impaired organ function, participation in additional exercise outside of NeuFit, or other stressors or health challenges, it may increase the risk of kidney-related conditions like rhabdomyolysis.

IV Therapy & Booster Shots, Nanoparticles

I have informed the qualified staff members of any known allergies to drugs or other substances, or of any past reactions to anesthetics. I have informed the qualified staff members of all current medications and supplements.

I understand that:

The procedure involves inserting a needle into a vein and injecting the prescribed solution intravenously.

Alternatives to intravenous therapy are oral supplementation and / or dietary and lifestyle changes.

Risks of intravenous therapy include but not limited to:

o Occasionally to commonly - Discomfort, bruising, pain at the site of injection.

o Rarely - inflammation of the vein used for injection, phlebitis, metabolic disturbances, and injury.

o Extremely Rarely - Severe allergic reaction, anaphylaxis, infection, cardiac arrest and death.

I understand that Toradol is administered in some of the IV’s. I have been made aware that Toradol can affect a person with kidney issues and have informed the nurse if I have a kidney issue.

I understand that a lactated ringer is used in some of the IV’s. I have been made aware that a lactated ringer IV solution can affect a person with severe liver issues and have informed the nurse if I have a liver issue.

I understand that the B-12 intramuscular shot can cause soreness and bruising in the arm and/or muscle.

NAD+ Therapy

The NAD+ protocol will consist of a 500mL bag of saline infused with a dose of NAD+ which is determined by our overseeing physician and will be specific to your needs. Treatment time can range from 2-4 hours and we recommend all clients hydrate prior, no alcohol consumption within 24 hours of treatment and eat a well balanced snack 30 minutes prior to appointment.

NAD+ is a nucleotide that is naturally present in the body. It is integral for normal cell functioning. NAD+ IV replacement is thought to be helpful for rejuvenation, body and brain health, physical recovery and other positive effects. However, it is not FDA approved for any medical indication. There are medical studies ongoing to look at NADs effects for a variety of indications, but for now there is no medical proof of its positive effects.

I understand the desired effect, improvement, or relief of any condition for which NAD+ is to be applied may or may not be attained. Moreover, NAD+ does not preclude the need for other forms of therapy, and I assume full responsibility for the treatment of my condition by other physicians practicing standard medicine, as may be deemed necessary for my well being.

I understand the possible benefits have been discussed with me including but not limited to the mitigation of some symptoms of illness, improved energy and focus, better energy production and metabolism, mitigation of detoxification and withdrawal symptoms.

I understand there may be complications resulting from this protocol which could include but are not limited to infection, nausea, vomiting, diarrhea, pain and discomfort, weakness, fainting, micro-hemorrhages, ecchymosis, embolism, allergic reactions, shock, IV fluid infiltration, swelling, needle breakage and its retention, death and even aggravation of current symptoms. Most clients report mild flu-like symptoms. I will let my clinician know if I begin to feel any of these symptoms so they can make the necessary adjustments to ensure my comfort.

I understand NAD+ should not be taken if you have a sensitivity to niacin, or to NAD+, B-Vitamins, nicotine, or nicotinamide as the possibility of an allergic reaction and severe reactions may exist.

I understand that the contradictions of NAD+ infusions are congestive heart failure, pregnancy, chronic kidney disease and active cancer.

Sculpsure Body and SculpSure Submental Treatment

Skin may be slightly pink to red immediately after treatment and could last up to a few days.
After treatment there may be swelling and tenderness that lasts approx. 2-3 (two to three) weeks, but may last longer. You may also experience tissue firmness or nodules. Nodules can last for days to several months, depending on the size of the nodule. This side effect typically resolves on its own. While uncommon, some nodules may be permanent.
I understand that the practice of medicine is not an exact science and no results have been guaranteed. I acknowledge that the results may not meet my expectations. I certify that no guarantees have been made by anyone regarding the procedure(s) that I have requested and authorized

Normatec Pulse Technology Contraindications

Do not use Normatec if you have or may have any of the following conditions: current or unstable fractures or breaks, recent surgery and have stitches or sutures, open wounds, contusions, or abrasions. If you have any other injury, illness or medical condition, you should consult your physician prior to using Normatec.

Procell MD Microchanneling

POSSIBLE RISKS AND SIDE EFFECTS ASSOCIATED WITH MICROCHANNELING

• CONTRAINDICATIONS: Any condition that seriously impairs your immune system, active radiation or chemotherapy, pregnant or nursing, uncontrolled diabetes, allergy to stainless steel, chronic inflammatory skin disease, Accutane in the past 2 years, hemophilia or similar bleeding disorder

• I understand that Microchanneling is non-ablative skin rejuvenation & involves the creation of perforations in my skin to promote healing responses to rejuvenate my skin. I understand that the procedure is performed with an automatic perforating device and that clinical results may vary. I understand there is a possibility of short-term effects such as reddening, peeling, scabbing, temporary bruising and temporary discoloration of the skin, as well as rare side effects such as infection & scarring. These effects have been fully explained to me.

Blood work

Possible Risk: The risks of having blood drawn from your arm include some pain when the needle goes in and a small risk of bruising and/or infection at that site. Some people get lightheaded, nauseous, or faint. You are less likely to have these problems if you drink at least 2 glasses of water and have a snack before the blood draw.

Platelet Rich Plasma (PRP) Therapy

No guarantee or assurance was made, as to the results that may be obtained from the procedure/treatment. Specifically the risks were identified including but are not limited to the following:

• Increased pain and allergic reaction from local anesthetics, iodine, contrast (X-Ray dye), materials containing latex, IV anesthetics and/or other medications

• Infection on skin, tissue, bones, joints, discs, nerves, ligaments, possibly blood stream (Sepsis), brain and spinal cord (Meningitis) may require hospitalization

• Bleeding into epidural space (Epidural Hematoma) and into spinal canal (Spinal Hematoma) may require surgical interventions such as an evacuation of blood from epidural space, spinal canal and decompression surgery, blood vessel injury

• Nerve damage, tissue injury, tissue damage, temporary and permanent numbness and/or weakness, paralysis, spinal cord injury, urinary and/or fecal incontinence

• Headache (“Spinal headache”) may require blood patch (Injecting your own blood into epidural space) and hospitalization

• Joint injection: In addition to the above complications, injection and fluid collection in the joint(s) may require antibiotic treatment, fluid aspiration and surgical interventions.

• Allergic reaction from steroid; facial flushing, elevation in blood glucose, headache, increased appetite, weight gain, swelling, menstrual irregularities, hoarseness, numbness, infection, abnormal heartbeats, increased blood pressure, stroke, heart attack, insomnia, etc.

• Death

Waiver of Liability, Assumption of Risk and Hold Harmless Agreement

I, , in consideration for using and as a condition of my use of any equipment, product or service including, but not limited to, Hyperbaric Oxygen Therapy, Softwave Therapy, Normatec, Thor Laser, Novothor Bed, SculpSure, Squid, Massage, Acupuncture, Hydrafacial, Facials, Botox , VI Peels, Procell Microchanneling, Celluma Light, Biomat , Theragun, IV Therapy & Vitamin Boosters, , Oxygen Therapy, , blood draws, Platelet Rich Plasma (PRP) therapy and all products, equipment, and services referred collectively as “activities”, have voluntarily chosen to participate in such activities with full knowledge of the risks and hazards described in the safety instructions set forth above and the release set forth below. In consideration of my participation, I acknowledge and agree that the activities may be strenuous and/or present an inherent risk of personal injury and property damage. I am responsible for consulting with my physician and ensuring that I am medically fit prior to participating. I represent and warrant that I am medically fit, have no known or suspected health conditions, including but not limited to preexisting injuries, illness or pregnancy, that prohibit or limit my participation in any activity in any manner, and am not under the influence of alcohol or drugs. At all times during my participation I will properly utilize all recommended safety equipment and follow all recommended instructions and procedures pertaining to the activity. While equipment, instructions and procedures may reduce inherent risk of the activity, I understand that a substantial risk of personal injury or property damage remain, and therefore, agree as follows:

1. ON BEHALF OF MYSELF, MY SPOUSE, CHILDREN (INCLUDING ANY OF WHICH I AM GUARDIAN), HEIRS, PERSONAL REPRESENTATIVES, EXECUTORS AND ASSIGNS AND ANYONE CLAIMING BY OR THROUGH ME OR ANY OF THE FOREGOING (‘RELEASORS’), I HEREBY VOLUNTARILY AGREE TO RELEASE, WAIVE, DISCHARGE, HOLD HARMLESS, DEFEND AND INDEMNIFY THE ENTITIES AND THEIR RESPECTIVE PREDECESSORS, SUCCESSORS, AFFILIATES, MEMBERS, OFFICERS, MANAGERS, DIRECTORS, OWNERS, SERVANTS, AGENTS, EMPLOYEES, INSURERS, ATTORNEYS AND VOLUNTEERS (HEREINAFTER REFERRED TO AS “RELEASEES’) FROM ANY AND ALL CLAIMS,DEMANDS, LIABILITIES, LOSSES, INJURIES, PERSONAL INJURIES, PROPERTY DAMAGE, WRONGFUL DEATH,LOSS OF SERVICES, DAMAGES, ACTIONS OR CAUSES OF ACTION,PRESENT OR FUTURE, WHATSOEVER ARISING OUT OF OR CONNECTED WITH THE ACTIVITIES, EQUIPMENT, PRODUCTS OR SERVICES OWNED, OFFERED OR PROVIDED BY THE ENTITIES, AND ANY EQUIPMENT, MACHINERY AND/OR FACILITIES OF ANY OF THE RELEASEES, EVEN IF CAUSED IN A WHOLE OR IN PART BY THE NEGLIGENCE OF ANY OF THE RELEASEES. I HAVE READ, UNDERSTAND AND VOLUNTARILY SIGN THIS DOCUMENT (INCLUDING THE WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT SET FORTH ABOVE) AND KNOWINGLY WAIVE ANY RIGHTS AGAINST, AND RELEASE THE RELEASEES FROM, ANY SUCH CLAIMS, DEMANDS, INJURIES, PERSONAL INJURIES, PROPERTY DAMAGE, WRONGFUL DEATH, LOSS OF SERVICES, DAMAGES, ACTIONS AND CAUSES OF ACTION.IT IS MY EXPRESS INTENTION TO EXEMPT AND RELIEVE THE RELEASEES FROM LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH.

2. I hereby confirm that no warranty or guarantee, or other assurance, has been made to me covering the results of any services, products or equipment offered by The Fix LLC or any of the RELEASEES and I hereby relieve them and hold them harmless from all liabilities for injury or damage that may occur to me. I fully understand the administration of the process, including possible adverse reactions, side effects, or other possible complications. I understand that this CONSENT is being given in advance of any administration of the process, and is being given by me voluntarily to use equipment and/or obtain services from The Fix LLC.

3. I am fully aware of the risks and hazards connected with the use of equipment and the services, including the risk of physical injury or disability as the result of such injury, and I am voluntarily participating in said equipment usage and the receipt of any services, and entering the above named premises and employees relating thereto. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY THAT MAY BE SUSTAINED, OR ANY LOSS OR DAMAGE TO PROPERTY AS A RESULT OF BEING ENGAGED IN SUCH AN ACTIVITY.

4. I understand that this document, including the Waiver of Liability and Hold Harmless Agreement, shall be construed in accordance with the laws of the State of COLORADO. If any provision of this document is held to be unenforceable, this document shall be considered divisible and such provision shall be deemed inoperative to the extent it is deemed unenforceable, and in all other respects this document shall remain in full force and effect; provided, however, that if any such provision may be made enforceable by limitation thereof, then such provision shall be deemed to be so limited and shall be enforceable to the maximum extent permitted by law.

5. I understand the RELEASEES will not be responsible for any medical costs associated with any injury.

6. I have read the instructions for proper use of facilities and equipment and do so at my own risk and hereby release the owners, operator, franchisers, manufacturers, employees, contractors from any and all damage or harm that I might incur due to use of the facilities and equipment.

My signature below constitutes my knowledge that (1) I have read, understand, and fully agree to all of the foregoing, (2) the proposed indoor process and all activities has been satisfactorily explained to me and I have all of the information I desire and (3) I hereby give my authorization and consent. This CONSENT shall stand as long as I use any equipment or obtain any products or services at any facility utilized by The Fix LLC.

IN SIGNING THIS DOCUMENT, I ACKNOWLEDGE AND REPRESENT THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT, INCLUDING THE WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT, I AM AT LEAST (18) YEARS OF AGE AND FULLY COMPETENT; I HAVE GIVEN UP CONSIDERABLE FUTURE LEGAL RIGHTS; AND I EXECUTE THIS DOCUMENT FREELY, VOLUNTARILY, UNDER NO DURESS OR THREAT OF DURESS, WITHOUT INDUCEMENT, PROMISE OR GUARANTEE BEING COMMUNICATED TO ME. FURTHERMORE, I AGREE THAT I WILL COMPLY WITH ALL INSTRUCTIONS ON THE USE OF ALL OTHER EQUIPMENT AND THAT I AM USING SUCH EQUIPMENT AND OBTAINING SERVICES AT MY OWN RISK, I AGREE TO USE ALL SESSIONS WITHIN THE TERMS OF THE CONTRACT DATES (6 months from purchase date) AND UNDERSTAND THAT REFUNDS ARE NOT GIVEN ON UNUSED PORTIONS OF PURCHASED PACKAGE.

The Fix Photography Release
I hereby grant The Fix permission, if granted by myself during service, to use my photograph/video in any and all of its publications, including but not limited to all of The Fix’s printed and digital publications. I understand and agree that any photographs/videos will become the property of The Fix. I acknowledge that since my participation with The Fix is voluntary, I will receive no financial compensation. I hereby authorize The Fix to edit, alter, copy, exhibit, publish, or distribute this media. I waive the right to inspect or approve the finished product, including a written or electronic copy.

Merchandise Returns
Refunds or exchange of merchandise is NOT permitted after purchase. Return credit will be not be issued on merchandise or product wanting to be returned once client has left the studio.

Package Expiration
If a client purchases a pre-paid service package for any treatment, including but not limited to, Softwave, Hyperbaric, NovoThor, Etc. Sessions will remain valid for 6 months. After 6 months from purchase date, any remaining sessions on package will become invalid. No refunds or echanges permitted.

Privacy and SMS Consent
By signing this waiver and intake form, you agree to The Fix Recovery Therapy’s Privacy Policy and SMS Consent. We collect, use, and protect your personal information as outlined in our policy. This includes contact details, appointment information, and any additional data provided for scheduling, billing, and communication purposes. You consent to receive SMS messages (e.g., appointment reminders, billing inquiries) with the option to opt-out at any time by replying "STOP."

Service Fee for Credit Card Transactions
A 3% service fee will be added to all credit card transactions. This fee does not apply to debit cards, cash, or checks.

Late Arrival, Cancellation and No Show Policies

Late Arrival

All clients are asked to arrive at least 5 minutes before your scheduled appointment time. Therapists cannot go over the allotted time since most sessions are booked back to back. If a client is more than 15 minutes late for a 30 minute session OR 20 minutes late for a 60 minute session, the appointment is considered a “NO SHOW”.

No Show Policy
If a client is a “No Show” an appointment will be considered a cancellation and be charged the session rate. If a clients’ card is on file The Fix has permission to charge the card for service missed without client disputing. An exception will be made if there is a contagious illness, sudden emergency or inclement weather.

Cancellation Policy

All cancellations require 48 hour notice. Any cancellation made less than 48 hours from the session time will be charged the session rate. If a clients’ card is on file The Fix LLC has permission to charge the card for service missed without client disputing. An exception will be made if there is a contagious illness, sudden emergency or inclement weather.

Privacy and SMS Consent

By signing and accepting this waiver and intake form, you agree to The Fix Recovery Therapy’s Privacy Policy and SMS Consent. We collect, use, and protect your personal information as outlined in our policy, including contact details, appointment information, and any additional data provided for scheduling, billing, and communication purposes. You consent to receive SMS messages (e.g., appointment reminders, billing inquiries) with the option to opt-out at any time by replying 'STOP.' Message and data rates may apply, and messaging frequency may vary. Visit thefixaspen.com/privacy-policy/ to see our Privacy Policy and Terms of Service.

SMS Opt In:

Participant’s Printed Name:
Signature:

Clear

(draw your signature)

Date:

Name of Adult Participant and/or Parent or Legal Guardian of Minor:

First Name:	Last Name:	Birth Date:
Address:	City:	State:
		Country:
Zip:	Email:	Phone:

Relationship to minor:

Full Name and Birth Date of family members under the age of 18

#1	First Name:	Last Name:	Birth Date:
#2	First Name:	Last Name:	Birth Date:
#3	First Name:	Last Name:	Birth Date:
#4	First Name:	Last Name:	Birth Date:
#5	First Name:	Last Name:	Birth Date:
#6	First Name:	Last Name:	Birth Date:
#7	First Name:	Last Name:	Birth Date:
#8	First Name:	Last Name:	Birth Date:
#9	First Name:	Last Name:	Birth Date:
#10	First Name:	Last Name:	Birth Date:

Put Your Legal Signature Below

Clear

Date and Time Signed:

By checking this box, I have read and agree to the legal agreement above AND I consent to receive SMS messages from The Fix about account management, appointment scheduling, and confirmations. Reply STOP to opt-out; Reply HELP for support; Message & data rates may apply; Messaging frequency may vary. Visit thefixaspen.com/privacy-policy/ to see our privacy policy and thefixaspen.com/privacy-policy/terms-of-service/ for our Terms of Service.

Send me emails about Account Management, Reminders, and Schedule Changes

Send a copy of this waiver to my email

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Our Privacy Policy

PLEASE NOTE THAT WAIVERKING, INC.’S (“WaiverKing”) PRIVACY POLICY HAS CHANGED EFFECTIVE May 25th, 2018.

You acknowledge that this privacy policy is a part of our website’s Terms of Service, and by accessing or using our website, you agree to be bound by all of its terms and conditions. IF YOU DO NOT AGREE TO THESE TERMS, AS UPDATED, PLEASE IMMEDIATELY STOP ACCESSING THE WEBSITE.

This document explains how we use your personal data.

When you sign up to use this service provider’s services, you do so through software provided by us, WaiverKing.

We are committed to ensuring the privacy of all users of our software and services and other visitors to our website. In this policy we explain how we hold, process and retain your personal data.

In respect to the account data, waiver data, and payment data (as defined below) that you provide to us, we are acting as a data processor on behalf of the service provider, who will be acting as the data controller in respect to such data. We will never store or control this data. You should direct any requests or queries you have regarding this data to the data controller, your service provider.

1. How we use your personal data

1.1. This section provides you with information about:

a) what personal data we hold and process;

b) in respect of personal data that we did not collect from you directly, where we obtained that data from, and what types of data we have collected;

c) the purposes for which we may process your personal data; and

d) the legal grounds on which we process your data.

Members and end users of our services

1.2. Account data. We may process information about you that you provide to us when you first sign up with a service provider ("account data"). This account data may include your name, address, telephone number, email address, date of birth, gender, employment details, and a photograph of you. We may use this data to create your account with the service provider when you sign up. This account data may be updated each time you complete a document through our software. We do not process your account data in any other way, or have access to it in any way.

The legal basis for this processing is our legitimate interests in providing our services to our clients, and ensuring that your account is updated each time that you complete a document through our software.

1.3. Waiver data. If you are using our software in order to sign documents such as a waiver, health form, contract, or questionnaire, we may process information that you put into such documents (“waiver data”). This waiver data may include your name, signature, date of birth, email address, information about your health and medical history, and any other information that you are required or requested to put into the document.

Once you have completed the document, we will process it, convert the document into a different format, and send it to your account with the service provider in order for it to be stored. We will never store your data permanently on our systems (although it may be stored in your account with your service provider).

The purpose for our processing your data in this way is to maintain and administer a complete and accurate record of the documents that you have signed and completed for your service provider. The legal basis for our processing your waiver data (to the extent that such waiver data does not class as a special category of personal data), will be our legitimate interests in providing our services to our clients who have asked you to complete the document in question, in order to ensure that a complete and accurate record of your signing and completing the documents is maintained and administered.

1.4. Sensitive Personal Data. During the course of using our software and services and providing us with information in order for us to provide our services to you, you may provide us with sensitive information about yourself (“sensitive data”). This sensitive data may include your health and medical history. We may use this data for providing our services to you. However, we will only process this sensitive data if you consent to us doing so.

[The consent to use this information needs to be provided by the parent for children under the age of 13. Anyone over the age of 13 can provide consent for use of their data under GDPR]

We comply with the requirements of the Children’s Online Privacy Protection Act. You must be at least 18 years old to have our permission to use the WaiverKing website. If you are between the ages of 13 and 17, or under the age of majority where you live, you represent that your legal guardian has reviewed and agreed to this privacy policy.

Other processing that we may carry out

1.5. Website data. We may process data about your use of our website and services ("website data"). The website data may include your IP address, geographical location, browser type and version, operating system, referral source, length of visit, page views and website navigation paths, as well as information about the timing, frequency and pattern of your service use. The source of the website data is our analytics tracking system. This website data may be processed for the purposes of analyzing the use of the website and services.

The legal basis for this processing is our legitimate interests, namely monitoring and improving our website and services.

We may also process this data for the purposes of diagnosing any issues we detect in relation to the use of our products or services. This data may be collected by our error-tracking software which is provided by Rollbar. We always try to ensure that any such data is anonymized so that you cannot be identified before it is stored in our records.

The legal basis for this processing is our legitimate interests in monitoring and improving our products and services.

1.6. Enquiry data. We may process information contained in any enquiry you submit to us regarding our products or services ("enquiry data"). The enquiry data may be processed for the purposes of offering, marketing and selling relevant products and/or services to you.

The legal basis for this processing is our legitimate interests, namely dealing with and responding to your enquiry appropriately.

1.7. Notification data. We may process information that you provide to us for the purpose of subscribing to our blog and press releases ("notification data"). The notification data may be processed for the purposes of sending you newsletters.

Where you are a corporate customer, the legal basis for this processing is our legitimate interests, namely the marketing of relevant products and services to you.

1.8. Correspondence data. We may process information contained in or relating to any communication that you send to us ("correspondence data"). The correspondence data may include the communication content and metadata associated with the communication. Our website will generate the metadata associated with communications made using the website contact forms. The correspondence data may be processed for the purposes of communicating with you and record-keeping.

The legal basis for this processing is our legitimate interests, namely the proper administration of our website and business and communications with users.

1.9. Payment data. We do not process payment information relating to goods and services that you purchase from the service provider. However, we do capture certain data relating to your payments and use them to update your account with the service provider ("payment data"). The payment data may include your contact details, your card details and the transaction details. The payment data may be processed for the purposes of updating your account with the service provider. The legal basis for this processing is our legitimate interests, namely our interest in the proper administration of our software and ensuring your account with the service provider is updated.

1.10. Other processing activities. In addition to the specific purposes for which we may process your personal data set out above, we may also process any of your personal data where such processing is necessary for compliance with a legal obligation to which we are subject, or in order to protect your vital interests or the vital interests of another natural person.

2. Providing your personal data to others

2.1. To our clients and partner service providers. The only third parties that we will disclose your personal data to are our clients (your service provider) who is the data controller in respect to the account data, waiver data, and payment data that we collect about you, and MINDBODY Inc. (“MINDBODY”), who provide software services to service providers in conjunction with the WaiverKing software. Your accounts are created by WaiverKing in the MINDBODY software on behalf of our clients.

2.2. Our insurers/professional advisers. We may disclose your personal data to our insurers, legal counsel, and/or professional advisers insofar as reasonably necessary for the purposes of obtaining and maintaining insurance coverage, managing risks, obtaining professional advice and managing legal disputes.

2.3. Where we provide your personal data to any third party. Where we share your personal data with any of the third parties referred to above, we will ensure this processing is protected by appropriate safeguards including a suitable data processing agreement with that third party.

2.4. To comply with legal obligations. In addition to the specific disclosures of personal data detailed above, we may also disclose your personal data where such disclosure is necessary for compliance with a legal obligation we have to comply with, or in order to protect your vital interests or the vital interests of another individual. This may include disclosing your personal data in response to lawful requests by public authorities, including to meet national security or law enforcement requirements.

2.5. We take reasonable and appropriate steps to ensure that third-party agents and service providers process your personal data in accordance with our Privacy Shield obligations and to stop and remediate any unauthorized processing. Under certain circumstances and pursuant to applicable laws, we may remain liable for the acts of our third-party agents or service providers who perform services on our behalf for their handling of your personal data that we transfer to them.

3. Transfers of your personal data outside of the European Economic Area

As further detailed below, we may transfer your personal data to our servers based in the US, as we are part of the Privacy Shield. Otherwise, where your personal data is transferred outside of the EEA, we will ensure that either (a) The European Commission has made an "adequacy decision" with respect to the data protection laws of the country to which it is transferred, or (b) we have entered into a suitable data processing agreement with the third party situated in that country to ensure the adequate protection of your data. In all cases, transfers outside of the EEA will be protected by appropriate safeguards.

4. Retaining and deleting personal data

4.1. Personal data that we process for any purpose or purposes shall not be kept for longer than is necessary for that purpose or those purposes. Details about members of our clients (your service provider) and end users of our services, including the account data, waiver data and sensitive personal data, will not be stored by WaiverKing.

4.2. Unless we contact you and obtain your consent for us to retain your personal data for a longer period, we will retain and delete your personal data as follows:

a) Website data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

b) Enquiry data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

c) Notification data (other than Notification data that is also Contact data) will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

d) Correspondence data will be retained for 12 months following the date of our last contact or dealing with you, at the end of which period it will be deleted from our systems.

4.3. We may retain your personal data where such retention is advisory and/or necessary for compliance with a legal obligation to which we are subject (such as with regard to applicable statutes of limitations, litigation or regulatory investigations), or in order to protect your vital interests or the vital interests of another natural person.

5. Your rights

5.1. You may instruct us to provide you with any personal information we hold about you; provision of such information will be subject to:

a) your request not being found to be unfounded or excessive, in which case a charge may apply; and

b) the supply of appropriate evidence of your identity (for this purpose, we will usually accept a notarized photocopy of your driver’s license and/or passport and an original copy of a utility bill showing your current address).

5.2. We may withhold personal information that you request to the extent permitted by law.

5.3. You may instruct us at any time not to process your personal information for marketing purposes.

5.4. In practice, you will usually expressly agree in advance to our use of your personal information for marketing purposes, or we will provide you with an opportunity to opt out of the use of your personal information for marketing purposes.

5.5. Your right to access your data. You have the right to ask us to confirm whether or not we process your personal data and, to have access to the personal data, and any additional information. That additional information includes the purposes for which we process your data, the categories of personal data we hold and the recipients of that personal data. You may request a copy of your personal data. The first copy will be provided free of charge, but we may charge a reasonable fee for additional copies.

5.6. Your right to correct. If we hold any inaccurate personal data about you, you have the right to have these inaccuracies corrected. Where necessary for the purposes of the processing, you also have the right to have any incomplete personal data about you completed.

5.7. Your right to erasure. In certain circumstances you have the right to have personal data that we hold about you erased. This will be done without undue delay. These circumstances include the following: (1) it is no longer necessary for us to hold those personal data in relation to the purposes for which they were originally collected or otherwise processed; (2) you withdraw your consent to any processing which requires consent; (3) the processing is for direct marketing purposes; and/or (4) the personal data have been unlawfully processed. However, there are certain general exclusions of the right to erasure, including where processing is necessary: for exercising the right of freedom of expression and information; for compliance with a legal obligation; or for establishing, exercising or defending legal claims.

5.8. Your right to restrict processing. In certain circumstances you have the right for the processing of your personal data to be restricted. These circumstances include the following: (1) you do not think that the personal data we hold about you is accurate; (2) your data is being processed unlawfully, but you do not want your data to be erased; (3) it is no longer necessary for us to hold your personal data for the purposes of our processing, but you still require that personal data in relation to a legal claim; and/or (4)you have objected to processing, and are waiting for that objection to be verified. Where processing has been restricted for one of these reasons, we may continue to store your personal data. However, we will only process it for other reasons: with your consent; in relation to a legal claim; for the protection of the rights of another natural or legal person; or for reasons of important public interest.

5.9. Your right to object to processing. You can object to us processing your personal data where our legal basis for the processing is that it is necessary for: the performance of a task carried out in the public interest, or in the exercise of any official authority vested in us; or the purposes of our legitimate interests or those of a third party. If you make an objection, we will stop processing your personal information unless we are able to: demonstrate compelling legitimate grounds for the processing, and that these legitimate grounds override your interests, rights and freedoms; or the processing is in relation to a legal claim.

5.10. Your right to object to direct marketing. You can object to us processing your personal data for direct marketing purposes. If you make an objection, we will stop processing your personal data for this purpose.

5.11. Your right to data portability. Where you have given us consent to process your personal data, or where we are processing your personal data for the performance of a contract, you have a legal right to receive a copy of the personal data we hold about you in a structured, commonly used and computer readable format. When a data request is made of us we will make available all applicable personal data to you in a computer readable format and will transmit your personal data to the appropriate third party pursuant to your instruction. We will not process your data in this way if we believe that it may pose a threat to the security of the data.

5.12. Your right to object for statistical purposes. You can object to us processing your personal data for statistical purposes on grounds relating to your particular situation, unless the processing is necessary for performing a task carried out for reasons of public interest.

5.13. Automated data processing. To the extent that the legal basis we are relying on for processing your personal data is consent, and where the processing is automated, you are entitled to receive your personal data from us in a structured, commonly used and computer-readable format. However, you may not have this right if it would adversely affect the rights and freedoms of others.

5.14. Complaints to a supervisory authority pursuant to the GDPR. If you think that our processing of your personal data infringes data protection laws, you can lodge a complaint with a supervisory authority responsible for data protection. You may do this in the EU member state of your habitual residence, your place of work or the place of the alleged infringement. This provision is only applicable if you are subject to the protections of the GDPR.

5.15. Complaints if you are not subject to the protections of the GDPR. If you think that our processing of your personal data infringes data protection laws you may contact us via email at privacy@waiverking.com or mail at: WaiverKing, Inc. 340 S Lemon Ave # 2018 Walnut, California 91789.

5.16. Right to withdraw consent. To the extent that the legal basis we are relying on for processing your personal data is consent, you are entitled to withdraw that consent at any time. Withdrawal will not affect the lawfulness of processing before the withdrawal.

5.17. Exercising your rights. You may exercise any of your rights in relation to your personal data by written notice to us in addition to the other methods specified above.

5.18. Point of Contact Data. PARAGRAPHS 5.1 – 5.17 SHALL NOT APPLY TO ACCOUNT DATA, WAIVER DATA, OR PAYMENT DATA OBTAINED OR PROCESSED BY WAIVERKING. IN RESPECT OF SUCH DATA:

a) WAIVERKING IS ACTING AS A PROCESSOR OF THAT DATA AND THE MAIN CONTRACTOR IS THE CONTROLLER;

b) YOU SHOULD CONTACT THE SERVICE PROVIDER TO EXERCISE THE RIGHTS SET OUT IN THIS PARAGRAPH 5

6. Links To Other Websites. Except as otherwise discussed in this privacy policy, this document only addresses the use and disclosure of information we collect from you. Other websites accessible through our website have their own privacy policies and data collection, use, and disclosure practices. Please consult each website’s privacy policy. We are not responsible for the policies or practices of third parties, including any third-party site or other products and services used in connection with WaiverKing’s services. The inclusion of a link does not imply endorsement of the linked site or service by us or by our affiliates.

We are not responsible for the collection, usage and disclosure policies and practices (including the data security practices) of other organizations, such as, Apple, Google, Microsoft, or any other operating system provider, wireless service provider or device manufacturer, including any personal data you disclose to other organizations through or in connection with WaiverKing’s services.

7. Security of Your Information. The security of personal data is a high priority at WaiverKing. We seek to use reasonable technical, administrative and physical safeguards to protect personal data within our organization. Unfortunately, no data transmission or storage system can be guaranteed to be 100% secure. As a result, while we strive to protect your personal data, you acknowledge that: (a) there are security and privacy limitations of the Internet which are beyond our control; (b) the security, integrity, and privacy of any and all information and data exchanged between you and us through the website cannot be guaranteed; and (c) any such information and data may be viewed or tampered with in transit by a third party.

8. IP Addresses and Cookies. Cookies are very small text files that are stored on your computer when you visit some websites.

We use cookies to help identify your computer, including where available, your IP address, operating system and browser type, for system administration so we can keep your activity secure, tailor your user experience and remember your preferences. This is statistical data and does not identify any individual. You are always free to decline our cookies if your browser permits, but some parts of our website may not work properly.

9. Your California Privacy Rights: Notice to California Customers and Opt-Out Information. Residents of the State of California, under certain provisions of the California Civil Code, have the right to request from companies conducting business in California a list of all third parties to which the company has disclosed certain personal data, as defined under California law, during the preceding year for third party direct marketing purposes. You are limited to one request per calendar year. In your request, you must supply appropriate evidence of your identity and attest to the fact that you are a California resident and provide a current California address for our response. You may request the information by writing to privacy@waiverking.com

Some web browsers incorporate a “Do Not Track” feature that signals to websites that you visit that you do not want to have your online activity tracked. California residents are entitled to know how WaiverKing, Inc. responds to “Do Not Track” signals. How browsers communicate the Do Not Track signal is not yet uniform, so a standard technological response has not yet been developed by the appropriate technology communities. For this reason, we do not respond to Do Not Track signals currently. To opt out of direct advertising on our website, please send a request to the address above. The effect of an opt-out will be to stop direct advertising, but it will still allow the collection of usage data for certain purposes (e.g., research, analytics, and internal online services operation purposes).

10. Privacy Shield Framework

10.1. WaiverKing Inc. complies with the EU-U.S. and Swiss-U.S. Privacy Shield Framework as set forth by the U.S. Department of Commerce regarding the collection, use, and retention of personal information transferred from the European Union and Switzerland to the United States. WaiverKing has certified to the Department of Commerce that it adheres to the Privacy Shield Principles. If there is any conflict between the terms in this privacy policy and the Privacy Shield Principles, the Privacy Shield Principles shall govern. To learn more about the Privacy Shield program, and to view our certification, please visit https://www.privacyshield.gov/

10.2. In compliance with the Privacy Shield Principles, WaiverKing commits to resolve complaints about our collection or use of your personal information. Any individual(s) with inquiries or complaints regarding our Privacy Shield policy should contact us at: privacy@waiverking.com

10.3. WaiverKing Inc. has further committed to refer unresolved Privacy Shield complaints to Judicial Arbitration and Mediation Services (JAMS), an alternative dispute resolution provider located in the United States. If you do not receive timely acknowledgment of your complaint from us, or if we have not addressed your complaint to your satisfaction, please visit https://www.jamsadr.com/eu-us-privacy-shield for more information or to file a complaint. The services of JAMS are provided at no cost to you. In certain situations, you may also have the right to pursue binding arbitration under the Privacy Shield Framework.

10.4. You may have the option to select binding arbitration for the resolution of your complaint under certain circumstances, provided you have taken the following steps: (1) raised your complaint directly with WaiverKing Inc. and provided us the opportunity to resolve the issue; (2) made use of the independent dispute resolution mechanism identified above; and (3) raised the issue through the relevant data protection authority and allowed the U.S. Department of Commerce an opportunity to resolve the complaint at no cost to you. For more information on binding arbitration, see U.S. Department of Commerce's Privacy Shield Framework: Annex I (Binding Arbitration).

10.5. For purposes of enforcing compliance with the Privacy Shield, WaiverKing is subject to the investigatory and enforcement authority of the U.S. Federal Trade Commission.

10.6. WaiverKing Inc. is controlled and operated by us from the United States. Except where you are a resident of a Member State of the EU, in which case paragraphs 2 and 3 above will apply, your personal data may be stored and processed in any country in which we engage service providers, and by using WaiverKing’s services you understand that your information may be transferred to countries outside of your country of residence, including the United States, which may have data protection rules that are different from those of your country. In certain circumstances, courts, law enforcement agencies, regulatory agencies or security authorities in those other countries may be entitled to access your personal data. Regardless of where your information is processed, we apply the same protections described in this policy.

11. Changes to the privacy policy. We reserve the right to change this policy at any time, without prior notice to you. Such changes, modifications, additions, or deletions shall be effective immediately upon notice thereof, which may be given by means including, but not limited to, issuing an e-mail to the e-mail address provided by you or posting the revised policy on this page. You acknowledge and agree that it is your responsibility to maintain a valid e-mail address and/or review the WaiverKing website and this policy periodically, and be aware of any modifications. Your continued use of the WaiverKing website after such modifications will constitute your: (a) acknowledgment of the modified policy; and (b) agreement to abide and be bound by the modified policy.

12. Our details

12.1. This website and software is owned and operated by WaiverKing Inc.

12.2. We are registered in the state of California under registration number C3518177, and our registered office is at 340 S Lemon Avenue, # 2018 Walnut, California 91789.

12.3. You can contact us:

a) by mail, using the postal address given above;

b) using our website contact form;

c) by telephone, on the contact number published on our website from time to time; or

d) by email, using the email address published on our website from time to time.

13. Data protection officer

Our data protection officer may be contacted via email: privacy@waiverking.com, or telephone: +1 (888) 211-6693.

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