HEALTH SOLUTIONS 101 PTY LTD t/a WATER TEMPLE
ASSUMPTION OF RISK, WAIVER, AND RELEASE FROM LIABILITY
In consideration of the use of the WATER TEMPLE facilities, the undersigned agrees as follows:
1. RISK FACTORS: The undersigned understands and acknowledges that the use of equipment, facilities and services provided by WATER TEMPLE (floatation/isolation tank, and ancillary activities like walking on wet bathroom floor, showering, etc.) involves risks such as, but not limited to, the following which might result from the use of the facilities, from the activity itself, from the acts of others, or from the unavailability of emergency or emergency medical care: RISK OF PROPERTY DAMAGE, BODILY INJURY, AND POSSIBLE DEATH.
2. ASSUMPTION OF RISK. The undersigned ASSUMES ALL RISKS THAT ARISE OUT OF THE USE OF THE FACILITIES, THE ACTIVITY ITSELF, THE ACT OF OTHERS, OR THE UNAVAILABILITY OF EMERGENCY CARE, including but not limited to, those RISK FACTORS described in section 1 above.
3. ACKNOWLEDGMENT OF POLICIES AND PROCEDURES. The undersigned acknowledges knowing all of the policies and procedures relating to the activities, facilities, and/or equipment and understands that the safe and proper use of the facilities, equipment or participation in the activity is dependent upon carefully following such policies and procedures.
4. PREREQUISITE PHYSICAL AND MENTAL HEALTH. The undersigned acknowledges that he or she has the requisite physical and mental health and abilities for proper and safe use of the equipment and facilities and to participate in the activity itself. The undersigned warrants that he or she is not under the influence of any drugs, either recreational or prescription, which could cause panic, claustrophobia or otherwise interfere with the proper and safe use of the equipment and facilities. The undersigned agrees that if he or she has any questions as to what skills, qualifications or training is necessary to properly use the equipment, facility, or to participate in the activity itself, then they shall direct such questions to the appropriate staff member on site. The undersigned is encouraged to have a physical examination prior to any and all participation.
5. RELEASE. The undersigned RELEASES WATER TEMPLE and its employees and agents from any and all legal liability, and agrees NOT TO SUE them on account of or in conjunction with any claims, causes of action, injuries, damage, cost of expenses arising out of the activity, including those based on death, bodily injury or property damage whether or not caused by the acts, omissions or other fault of the parties being released.
6. WAIVER. The undersigned waives the protection afforded by any statute or law in any jurisdiction whose purpose, substance, and/or effect is to provide that a general release shall not extend to claims, material or otherwise which the person giving the release does not know of or suspect at the time of executing the release. This means, in part, that the undersigned is releasing unknown future claims.
7. PAY. The undersigned agrees to pay for any or all damages to any property or indemnities caused by the undersigned either negligently, wilfully, or otherwise.
8. REPRESENTATIVES. The undersigned enters into this agreement for himself/herself, his/her heirs, assigns and legal representatives.
9. EMERGENCY TREATMENT CONSENT. The undersigned, as a participant in the subject activity, hereby consents to medical treatment in a medical emergency where the undersigned is unable to consent to such treatment.
10. WARNING UNDER THE AUSTRALIAN CONSUMER LAW AND FAIR TRADING ACT 2012
Under the Australian Consumer Law (Victoria), several statutory guarantees apply to the supply of certain goods and services. These guarantees mean that the supplier named on this form is required to ensure that the recreational services it supplies to you-
• are rendered with due care and skill; and
• are reasonably fit for any purpose which you, either expressly or by implication, make known to the supplier; and
• might reasonably be expected to achieve any result you have made known to the supplier.
Under section 22 of the Australian Consumer Law and Fair Trading Act 2012, the supplier is entitled to ask you to agree that these statutory guarantees do not apply to you. If you sign this form, you will be agreeing that your rights to sue the supplier under the Australian Consumer Law and Fair Trading Act 2012 if you are killed or injured because the services provided were not in accordance with these guarantees, are excluded, restricted or modified in the way set out in this form.
NOTE: The change to your rights, as set out in this form, does not apply if your death or injury is due to gross negligence on the supplier's part. Gross negligence, in relation to an act or omission, means doing the act or omitting to do an act with reckless disregard, with or without consciousness, for the consequences of the act or omission. See regulation 5 of the Australian Consumer Law and Fair Trading Regulations 2012 and section 22(3)(b) of the Australian Consumer Law and Fair Trading Act 2012.
11. ACKNOWLEDGMENT. The undersigned has read and understands this agreement and realises it relates to surrendering valuable legal rights and does so freely and voluntarily.