Assumption of Risks: Ashai Health has facilities for and provides for activities such as Cryotherapy, IM medication, IV nutritional therapy, Ketamine, NormaTec, NuCalm, and red-light therapy. Each of these activities have inherent risk, however rare. Cryotherapy involves exposures to extreme cold temperature for short periods of time. Client could possibly experience cold burn and/or frost bite. IV nutritional therapy requires placement of an intravenous catheter and infusion which could possibly result in allergic reaction, phlebitis, air embolism. IM medication administration requires a needle puncture through the skin to deliver medication which could result in allergic reaction, skin infection or other adverse reaction such as syncope.
Waiver: In consideration of permission to use, today and on all future dates the property, facilities, and services of Ashai and provider, I, on behalf of myself, my heirs, personal representatives, or assigns, do hereby release, waive, discharge, and covenant not to sue, Ashai, its principles, its directors, officers, employees, volunteers, independent contractors, and agents from liability from any and all claims arising from the ordinary negligence of provider or any of the aforementioned parties. This agreement applies to: 1) personal injury (including death) from accidents or illnesses arising from the participation in Cryotherapy, IM medication, IV nutritional therapy, Ketamine, NormaTec, NuCalm, and red-light therapy activities including, but not limited to, organized activities, classes, observation, and individual use of facilities, premises, or equipment; and to 2) any and all claims resulting from the damage to, loss of, or theft of property.
Indemnification and Hold Harmless: I agree to HOLD HARMLESS AND INDEMNIFY Ashai from all claims resulting from negligence and to reimburse them for any expenses incurred by Ashai in investigating and defending a claim or suit if my claim is withdrawn, or to the extent a court or arbitration determines that Ashai is not responsible for the injury or loss.
Severability and Venue: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. Likewise, I agree that if legal action is brought, it must be brought in Bell County, Texas.
Acknowledgement of Understanding: I have read this waiver of liability, indemnification, and assumption of risk agreement and fully understand its terms. I understand that I am knowingly and voluntarily giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily, and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law in the State of Texas.
