Safety Waiver

Customer Health Declaration and Responsibility Agreement

By signing this document, you confirm your understanding of the physical and mental requirements of participating in the Balance Retreat, including contrast therapy. You also agree to take personal responsibility for your health and well-being during the retreat.

1. Health Declaration (detailed health screening questionnaire will be sent after booking)

To the best of your knowledge:

1. Heart Health: You do not have any diagnosed heart conditions, including but not limited to arrhythmias, heart disease, or recent heart surgery.

2. Blood Pressure: You do not suffer from unregulated high or low blood pressure.

3. General Health: You feel physically and mentally well enough to participate in a retreat involving cold and heat exposure.

4. Medical Conditions: You do not have any medical condition that could be negatively impacted by cold or heat exposure (e.g., Raynaud’s syndrome, severe asthma, epilepsy, or other conditions that may pose a risk).

5. Pregnancy: You are not pregnant or aware of being pregnant.

2. Responsibility for Health and Safety

By signing this agreement, you acknowledge and agree that:

1. Voluntary Participation: Participation in the Balance Retreat is entirely voluntary.

2. Risk Awareness: You understand that contrast therapy involves cold and heat exposure, which may cause physical discomfort or other risks.

3. Medical Advice: You have sought medical advice if needed or deemed necessary prior to participation.

4. Responsibility: You take full responsibility for monitoring your condition during the session and will stop participating if you feel unwell or unsafe.

5. Instructions: You will carefully follow all instructions provided by the certified Thermalist® Method Instructor – Dina Guleryuz during the contrast therapy session.

3. Acknowledgement of Potential Risks

By signing this Safety Waiver, you acknowledge that contrast therapy may involve:

• Rapid changes in body temperature, which can temporarily impact heart rate and blood pressure.

• Physical discomfort, including sensations of cold or heat.

• Potential risks to individuals with undiagnosed medical conditions.

You understand these risks and confirm your willingness to participate with full awareness of them.

4. Disclaimer

Dina Guleryuz, a certified Thermalist® Method Instructor:

• Provides this retreat for general wellness purposes only.

• Does not offer medical advice, diagnoses, or treatment.

• Is not responsible for any adverse effects resulting from undisclosed medical conditions or failure to follow instructions.

5. Declaration of Understanding

By signing below, I confirm that I:

• Have read and understood this agreement in its entirety.

• Have disclosed all relevant health information to the instructor.

• Am responsible for my own health and will act within my physical and mental limits.