Home
Wellness Team
Fitness Services
Holistic Services
DW Community
Plans & Pricing
Book Online
DW In The Media
DW Franchise
More
Complete this form if:
You are not a member and you have booked a sauna session.
You are not a member and you are redeeming a sauna voucher win.
Personal Information
Health Information
Sauna Use
Acknowledgment of Risks and Waiver of Liability
Health problems that are contraindicated for Infrared Sauna Use:
Pregnancy
Cardiovascular Issues (Like Heart Failure, Hypertension)
Fever/Infection
Acute Joint Injuries
Bleeding Disorders
Impaired Sweating (MS, Diabetes With Neuropathy)
Being Under the Influence of Alcohol/Drugs
**If you have any of the above health related problems, you are not a good candidate for infrared sauna use and will need to be cleared by a medical professional before being able to participate.
Risk Acknowledgment: I understand that using an infrared sauna may pose health risks, especially for individuals with certain medical conditions. I have informed the sauna staff of all relevant health issues and have consulted a healthcare professional when necessary before deciding to use the sauna.*
Assumption of Risk: I acknowledge and voluntarily assume the risks associated with sauna use, understanding that there is a possibility of adverse physical effects, including but not limited to dehydration, fainting, heat stroke, or heart failure.*
Waiver of Liability: I hereby agree to release, waive, discharge, and covenant not to sue the facility, its officers, employees, or agents from any and all liabilities arising from bodily injury, accidents, or death that may occur as a result of my participation in sauna activities. This release extends to all claims of every kind or nature
whatsoever, foreseen or unforeseen, known or unknown.*
Emergency Procedures: I agree to immediately report any feelings of discomfort, dizziness, or other concerning symptoms to the staff and cease using the sauna if advised by staff or if such symptoms occur.*
Privacy Acknowledgment
Confidentiality Commitment: I acknowledge that the sauna facility commits to maintaining the confidentiality and privacy of all personal and health information provided in this form. Information will only be used to evaluate suitability for sauna use and manage my experiences appropriately.*
Data Usage: I consent to the collection, use, and, where necessary, the disclosure of my personal information as needed for the provision of sauna services. This may include sharing information with healthcare professionals under circumstances that require medical intervention.*
Rights to Access and Correction: I understand that I have the right to request access to my personal records held by the facility and can request corrections to any inaccuracies in my personal data.*
Security Measures: I acknowledge that the facility implements appropriate security measures to protect my personal data from unauthorized access, alteration, or destruction.*
31 W Church Street
Newark, OH 43055
(740) 280-2031
lcdestinationwellness@gmail.com
www.lcsdestinationwellness.com