WAIVER – lighthouseibiza.love

SPECIFIC WAIVER AND RELEASE FORM

Name

Birthday Date

Address

City

Province

Mobile

Email Address

Emergency Contact Name

Emergency Contact Number

Health Issues, Concerns, Goals:

Recommended to us by

Please read and Checkmark

LIGHTHOUSE IBIZA S.L. Shall not be liable under any theory or any purported damages or any and all consequences by user of the Energy Enhancement System Technology (EES system)™. Although there is ongoing medical and clinical research on the EEsystem it has not been rated or evaluated by the United States Food and Drug administration nor the American Medical Association. The EESystem Technology is not intended to diagnose, treat, cure, or even prevent disease. No guarantees are expressed or implied about the use of the Technology. Results may vary between individuals. Information and statements are made for educational purposes and are not intended to replace the advice of your doctor. Medical advice must be obtained from a qualified health care practitioner.
The EESystem Technology does not dispense medical advice, prescribe or diagnose illness. The views and advice expressed by the EESystem Technology are not intended to be a substitute for conventional medical service.

Detoxification Symptoms

I am aware that I may experience detoxification symptoms. I take full responsibility for drinking more water, taking sea salt baths, or other measures needed to facilitate the elimination of toxins as recommended by Lighthouse Ibiza and the EESystem

Diabetes Requirements

Please be informed that if you are a diabetic it is important to monitor your blood sugar as use of the EESystem Technology may lower the requirement of insulin following a session

Purpose Agreements

I agree to the recording of my experience in connection with research, education, and promotion of the EEsystem Technology. I acknowledge that Lighthouse Ibiza is and will be the sole owner of all rights in and to my experience with the EEsystem Technology in written or spoken form for the above purposes

Liabilities

I agree to indemnify and hold Lighthouse Ibiza S.L., its employees, and any third parties harmless from any and all liabilities, losses or damages caused by or arising in any manner from my participation and experience with the EESystem Technology.

I understand the Terms mentioned above regarding my Energy Enhancement System Technology experience. If I choose to end the session before the purchased time has expired, there is no refund. I have read, understood, and agree to the terms, conditions, and information written herein above. I take full and personal responsibility for the use of the EESystem Technology. In no way will I make a claim against Lighthouse Ibiza or its employees.

Your Signature

Date

SPECIFIC WAIVER AND RELEASE FORM

Newsletter

Subscribe

Lighthouse Ibiza

Useful Links

Information

Working Hours