Release of Liability and Waiver

By signing this Therapy Release of Liability and Waiver, I confirm that I recognize the inherent risks associated with using certain equipment and/or participating in Manual Physical Therapy and Strength Training programs. I acknowledge and agree that I am responsible for my own health (or that of the minor listed below, if applicable). I understand that the Therapy associates and/or technicians are not healthcare practitioners and cannot be expected to diagnose and/or treat individual health problems.

I understand that I am responsible for discussing any questions I may have concerning my (or my child’s) health conditions, if any, throughout any program or treatment provided by KinoFit Physical Therapy. If health-related symptoms occur, I will cease participation (or my child’s participation) and inform therapy personnel of the symptoms.

By voluntarily choosing to receive Therapy-related treatments and/or participate in Therapy-related activities and programs, I warrant that to the best of my knowledge, I (or my child) have no disability, impairment, or ailment that prevents safe participation in such treatments and activities.

Consequently, in light of the foregoing, I (or, if applicable, as the parent or guardian of the minor listed below) hereby release KinoFit Physical Therapy, PLLC, and waive any and all claims, liabilities, or damages for personal injuries that I (or my child) may experience directly or indirectly from receiving Therapy-related treatments, utilizing the equipment, and/or participating in programs or activities offered by KinoFit Physical Therapy.

I, the undersigned, also consent and agree that KinoFit Physical Therapy, PLLC, its employees, or private contractors have the right to take and share photographs, videos, or digital recordings of me (or my child, if applicable) throughout participation in Manual Physical Therapy and Strength Training programs.

By signing below, I give KinoFit Physical Therapy PLLC permission to provide Manual Physical Therapy treatment to myself (or my child, if applicable).