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    Whole-Body Cryotherapy Waiver / Release of Liability

    DO YOU HAVE – OR – HAVE YOU EVER HAD...(Check if answer is yes)

    What is Whole Body Cryotherapy?

    Whole-body cryotherapy is the exposure of a person’s skin to temperatures of -130 to - 170 degrees Celsius (- 238 to – 274 degrees Fahrenheit) for a short time (3 minutes or less). At this temperature, the body activates several mechanisms that have significant long-term medical and cosmetic benefits:
    The outer skin reacts to the cold by activating increased production of collagen in deeper layers of the skin (similar to laser treatments of the face, where very high temperatures are used). The skin regains elasticity and becomes smoother and even-toned, significantly improving cellulite and skin aging conditions. Skin vessels and capillaries undergo severe vasoconstriction (to keep the core temperature from dropping), followed by vasodilation after the procedure. Toxins and other stored deposits are flushed out of the layers of the skin and blood perfusion is improved after several treatments. The anti-inflammatory properties of cryotherapy are also used to treat chronic skin conditions such as psoriasis and dermatitis.

    Safety Instructions for Cryotherapy

    1. You must wear cotton socks and gloves to avoid chilblain.
    2. Treatments are limited to 3 minutes per session. Overexposure to the cold temperatures may cause chilblain;
    3. During treatment, you must avoid inhaling the nitrogen fumes; while non-toxic, they are devoid of oxygen and may cause fainting;
    5. You may end the procedure at any time if you experience any problems or anxiety;
    6. Abnormal skin sensitivity to cold may be caused by certain foods, cosmetics, or medication, including but not limited to the following: Tranquilizers, High blood pressure medication;
    7. A person who is less than (18) years of age may not use whole body cryotherapy without parental consent.


    Pregnancy, severe Hypertension (BP> 180/100), acute or recent myocardial infarction (heart attack; need to be cleared for exercise), arrhythmia, symptomatic cardiovascular disease, acute or recent cerebrovascular accident (stroke; need to be cleared for exercise), uncontrolled seizures, fever, symptomatic lung disorders, bleeding disorders, infection, claustrophobia, intolerance to cold, age less than 18 years (parental consent to treatment needed), incontinence.

    Possible Risks of Whole Body Cryotherapy

    Fluctuations in blood pressure (due to peripheral vasoconstriction, systolic blood pressure may briefly increase by up to 10 points during treatment. This effect should reverse after the end of the procedure, as peripheral circulation returns to a normal, allergic reaction to extreme cold (rare), claustrophobia, anxiety, activation of some viral conditions (cold sores), etc. due to stimulation of the immune system.


    1. In consideration for using the cryo device (Equipment), I hereby RELEASE, WAIVE, DISCHARGE IN ADVANCE, and HOLD HARMLESS P5 PERFORMANCE (hereinafter referred to as RELEASE) along with its DBA’s, OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, FRANCHISEE’S and VOLUNTEER’S from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any damage or injury that may be sustained by me, while using the equipment or due to the use of the equipment.
    2. I hereby confirm that no warranty or guarantee, or other assurance has been made to me covering the results of the cryo process. I have been explained and understand the administration of the process, including possible adverse reactions, side effects, or other possible complications. It is understood that this CONSENT is being given in advance of any administration of the process, and is being given by me voluntarily to use the Equipment.
    3.I am fully aware of the risks connected with the use of the Equipment, and I am voluntarily participating in said Equipment usage, and entering the above-named premises to engage in such usage. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS that may be engaged in such an activity.
    4. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASE from any costs that may incur due to the use of Equipment by me.
    5. It is my express intent that this Release and Hold Harmless Agreement shall bind my family members and shall be deemed a RELEASE, WAIVER, AND DISCHARGE of the above-named RELEASE. I hereby further agree that this Waiver of Liability and Hold Harmless Agreement shall be construed in accordance with the laws of the State of Texas.
    6. I understand that the Equipment is designed for fitness and appearance enhancing use only by persons in good general health. I have been advised that if I suffer from any medical condition or illness whatsoever, I am NOT TO USE the Equipment without my doctor’s written permission. If I should faint due to excess nitrogen inhalation, I hold myself responsible for all injuries should I fall, and the cryotherapy attendant has the right to assist me.
    My signature below constitutes my acknowledgment that (1) I have read, understand, and fully agree to the foregoing CONSENT, (2) the proposed indoor cryo process 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 the Equipment at the location now and in the future.
    IN SIGNING THIS RELEASE, I ACKNOWLEDGE AND REPRESENT THAT I have read and understand the foregoing Waiver of Liability and Hold Harmless Agreement, I am at least eighteen (18) years of age and fully competent; and I execute this Release for full, adequate, and complete consideration fully intending to be bound by same.
    Furthermore, I agree that I will comply with all instructions on the use of the cryo device and that I am using these services at my own risk. I agree to use all sessions within the terms of the contract dates and understand that refunds are not given on unused portions of purchased packages. By signing below, I affirm that I have read and fully understand the risks as outlined in this waiver. I VOLUNTARILY AGREE TO EACH OF THE TERMS AND PROVISIONS HEREIN AND SIGN THIS OF MY OWN FREE WILL

    Parental Consent Form for children (under age 18)


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