CONSENT TO RECEIVE REHAB/FITNESS SERVICES: I hereby consent to receive rehabilitation, recovery and/or fitness training services from the service providers at Wired Fitness. I understand that some accelerators may involve the placement of electrode pads on my hips, pelvis, and/or buttocks, as well as other areas of my body, and I will allow the Wired Fitness Practitioners to place the electrode pads on the locations mandated by the Wired Fitness accelerators. I also understand that the electrodes may leave temporary red marks on my skin, due to the increase in local blood flow. If at any point I feel uncomfortable with something I am being asked to do, I will bring it up to my Wired Fitness Practitioner and reserve the right to stop any activity with which I am uncomfortable.

RELEASE OF LIABILITY: In conjunction with my services at Wired Fitness and as part of the consideration for my treatment and/or training, I, my heirs, executors, spouse, successors, assigns, offspring, agents, and representatives expressly release, hold harmless, and indemnify Wired Fitness, its owners, agents, medical director(s) and advisors, employees, representatives, assignees, licensees, and invitees, from all liability for any services rendered.

MEDICAL ACCEPTABILITY: I am aware that this work can be physically demanding, and assert that I have been cleared for rigorous exercise by my medical professional. I also acknowledge that use of electrical stimulation is contraindicated or that precaution is suggested by the following conditions, and I assert that I DO NOT have: -Cancer -A Cardiac Pacemaker -Current Blood Clots I also assert that I am not pregnant.

WIRED FITNESS FEES: I understand that Wired Fitness Services are not covered by my medical insurance. I acknowledge that I am responsible for any and all fees incurred at the time of visit for these services, and I am fully aware of the amount of those fees. I also understand that I am responsible for payment of cancelled sessions IF I FAIL TO NOTIFY WIRED FITNESS OF THE CANCELLATION A MINIMUM OF 24 HOURS IN ADVANCE. All sales are final, and no refunds are given. Exceptions can be made for extreme circumstances on a case-by-case basis. IMAGE RELEASE: I understand that, from time to time, pictures or videos may be taken of the work that is going on at Wired Fitness and shared for marketing or educational purposes. I hereby grant Wired Fitness permission to use my likeness in video or photograph for its printed and digital publications, including social media platforms. I hereby release and hold harmless Wired Fitness from all claims, demands, and causes of action, which I, or anyone acting on my behalf, may have. In addition, I waive the right to inspect or approve the finished product and waive the right to any compensation arising out of the use of my likeness in any videos or photographs.

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