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Liability Form

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Please read this document carefully.

By signing below, you acknowledge and agree to the terms and conditions set forth in this disclaimer form for engaging in localized cryotherapy sessions provided by Cryotherapy Guys.*

Agree

Client Information

Full Name:*

Date of Birth:*

MM slash DD slash YYYY

Email Address:*

Phone Number:

1. I, the undersigned client, hereby acknowledge and understand that localized cryotherapy sessions involve certain risks and possible side effects. I have been informed and educated about the nature of the procedure, its potential risks, and benefits. I willingly consent to participate in localized cryotherapy sessions with full knowledge and understanding of the following:

Yes

No

2. Non-Surgical and Completely Safe: I understand that localized cryotherapy is a non-surgical procedure that utilizes extremely low temperatures for therapeutic purposes. It is considered to be a safe treatment option. However, I acknowledge that individual responses to the treatment may vary, and there is a minimal risk of certain side effects.

Yes

No

3. Potential Risk of Skin Burn: I understand that localized cryotherapy involves the use of extremely low temperatures, and there is a slight risk of skin burns if proper precautions are not taken or if I have sensitive skin. I will follow all safety instructions provided by the technician.

Yes

No

4. Skin Issues: I will inform the technician of any pre-existing skin conditions, injuries, or allergies that may affect the outcome of the localized cryotherapy session. It is my responsibility to notify the technician of any changes in my health or skin conditions before each session

Yes

No

5. Certified Technician: I acknowledge that the technician performing the localized cryotherapy session is certified and trained in the procedure. I understand that the technician will guide me throughout the process and address any concerns or questions I may have.

Yes

No

6. Session Duration: I understand that the average duration of a localized cryotherapy session is between 4 to 7 minutes. I will adhere to the specified time frame as advised by the technician.

Yes

No

7. Post-Treatment Care: I will refrain from exposure to extreme heat, including hot showers, saunas, or sunbathing, for a minimum of 1 hour after the localized cryotherapy session.

Yes

No

8. Treatment, Not a Cure: I understand that localized cryotherapy is a treatment method and not a cure for any medical condition or ailment. Results may vary, and it is recommended that I consult with a healthcare professional for any specific medical concerns.

Yes

No

9. Recommendation for Full Diagnosis: I acknowledge that the cryotherapy technician may recommend a Magnetic Resonance Imaging (MRI) scan or refer me to a healthcare professional for a full diagnosis and assessment of any underlying medical conditions. The localized cryotherapy session is not a substitute for a comprehensive medical evaluation.

Yes

No

10. Dry Skin and Free of Creams/Moisturizers: I acknowledge that prior to the localized cryotherapy session, my skin must be dry and free of any creams, lotions, oils, or moisturizers. I will follow the instructions provided by the technician regarding the preparation of my skin.

Yes

No

I have had the opportunity to ask questions regarding localized cryotherapy, and all my questions have been answered to my satisfaction. I acknowledge that the benefits and potential risks of localized cryotherapy have been explained to me, and I voluntarily assume those risks.

If the client is under the age of 18, a parent or legal guardian must sign this form and provide supervision during the session.

I hereby release and discharge Cryo Guys its owners, employees, agents, and "affiliates" from any and all claims, damages, liabilities, costs, or expenses arising out of or in connection with the localized cryotherapy sessions provided. I understand that Cryo Guys does not assume liability for any incidents, accidents, or injuries that may occur as a result of my presence at any location or any affiliated premises.

By signing below, I acknowledge that I have read and understood this waiver/disclaimer form in its entirety and agree to be bound by its terms and conditions.

Client Signature:*

Parent/Guardian Signature (if applicable):

Date:

MM slash DD slash YYYY

Date:

MM slash DD slash YYYY

Services*

$ 40 per treatment

No Of Treatment

We come to you for a Private Event:

To book us to come to your event you must sign up for a minimum of 10 Cryotherapy sessions priced at $40 which would total the $400 price.

$ 25 for 10 Minutes

$ 25 for 10 Minutes

$ 25 for 15 Minutes

Credit Card*

American Express

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MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Total

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About Us
Our Services
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Liability Form
Gallery
Shop E-Strip
Shop CryoGuys Sleeve
Book An Appointment