EFT Authorization: I, the undersigned parent or legal guardian, hereby authorize Tender Touch Therapy and Medical Support Services to initiate electronic fund transfers from my specified checking, savings, or credit card account for payment of my child’s membership dues. This authorization will remain effective until all charges assessed in connection with the services have been collected.
Membership Term and Continuation of Program: I understand and agree to maintain membership for the duration of the group. I acknowledge that I am liable for dues for the group, regardless of any change in circumstances or usage. Should my child wish to continue with the current phase or program beyond this Term, I understand that the agreement will automatically renew under the same conditions unless otherwise stated.
Payment and Program Acknowledgment: I agree to purchase the instruction for my child, supervised by qualified personnel trained in the procedures and traditions of the offered programs and events. Details regarding payment will be specified separately.
Compliance with Regulations: I agree to comply and to ensure my child complies with all rules, regulations, and policies set forth by Tender Touch Therapy and Medical Support Services, as may be amended from time to time.
Failure to Attend Classes and Termination: I acknowledge that if my child fails to attend the classes as agreed upon in this Agreement, or if I fail to comply with any of my obligations under this Agreement, Tender Touch Therapy and Medical Support Services reserves the right to terminate this Agreement.
Superseding Agreement: This Agreement supersedes any previous membership agreement or understanding, whether written or oral.
Medical Approval: I represent that my child is physically fit to receive and participate in the prescribed course of instruction. I acknowledge that the activity requires physical exertion that may be strenuous and cause physical injury. I have consulted with a physician regarding my child’s participation and have confirmed there are no medical conditions which would affect my child’s participation.
Liability Release:
RELEASE, INDEMNIFICATION, AND HOLD HARMLESS AGREEMENT
In consideration of participating in Medical Support Services and Tender Touch Therapy activities, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence Medical Support Services and Tender Touch Therapy and its owners, directors, officers employees, agents, volunteers, participants, and all other persons or entities acting for them (hereinafter collectively referred to as “Releasees”), on behalf of myself and my children, parents, heirs, assigns, personal representative and estate, and also agree as follows:
I acknowledge that participating in Medical Support Services and Tender Touch Therapy activities involved known and unanticipated risks, which could result in physical or emotional injury, paralysis, or permanent disability, death, and property damage. Other risks include but are not limited to broken bones, torn ligaments, or other injuries as a result of falling or contact with other participants, death as a result of drowning or brain damage caused by near drowning in pools, medical conditions resulting from physical activity, and damaged clothing or any other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity.
I expressly accept and assume all the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite the risks, in addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.
I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which are in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney’s fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs.
I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical condition, which could interfere with my safety in this activity, or else I am willing to assume – and bear the costs of – all risks that may be created, directly or indirectly, by any such condition.
If I file a lawsuit, I agree to do so in the state where Releasees’ facility is located, and I further agree that the substantive law of that state shall apply.
I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.
By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.
PHOTO/TALENT RELEASE: I hereby release, consent, and authorize Medical Support Services and Tender Touch Therapy to use my photo/likeness/voice, as it pertains to my participation with Medical Support Services and Tender Touch Therapy, in any manner for promotional efforts without expectation of or right to any reimbursement in connection with its use.
CONSENT TO MEDICAL TREATMENT: As the parent or legal guardian of the registrant, I hereby give consent for emergency medical care prescribed by a fully licensed Doctor of Medicine, Physical Therapist, or Occupational Therapist. This care may be given under whatever conditions are necessary to preserve life, limb, or wellbeing of my dependent.
I understand and agree to the Medical Support Services’ and Tender Touch Therapy’s Programming waiver and release.
In consideration of my child being permitted to participate in this activity, I further agree to indemnify and hold harmless releases from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with such participation by minor.
Photographic Release: I agree that Tender Touch Therapy and Medical Support Services, or any party designated by them, may photograph or film my child during their participation at the premises and use such photos or video footage for promotional, sales, publicity, and advertising purposes for all media, including the internet.
Account Default and Termination: If Tender Touch Therapy and Medical Support Services are unable to process my payment from the designated account provided by me, they are permitted to use any other account information provided as many times and as often as needed to replace the unpaid payments.
Privacy: Tender Touch Therapy and Medical Support Services are committed to protecting the privacy of my personal information. They make every effort to ensure that the information I share with them is recorded accurately, retained securely, and used only according to my wishes.
Contract Cancellation: I understand I may cancel this Agreement from the day I enter into the Agreement until 10 days after. If I cancel this contract, Tender Touch Therapy and Medical Support Services have 30 days to refund my money.
To cancel, you must give notice of cancellation to:
Tender Touch/Medical Support Services
13203 Globe Dr., Ste. 111,
Mount Pleasant, WI 53177
Groups@tendertouchtherapyllc.com
You must give notice of cancellation by a method that will allow you to prove that you gave notice, including registered mail, electronic mail, facsimile or personal delivery. If you send the notice of cancellation by registered mail, electronic mail, or facsimile, it doesn’t matter if Tender Touch/Medical Support Services receives the notice within the required period as long as you sent it within the required period.
By clicking the checkbox below, you accept and acknowledge the terms of the agreement outlined above.
