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Health and Waiver form for Floating Sound Bath

This form MUST be completed at least 48 hours prior to attending a Floating Sound Bath hosted by The Well-Being Hub. If this form is not completed you will not be allowed to attend the event, If you attend the event without completing this form you will be refused entry and no refund will be given. 

 
Birthday
Day
Month
Year
Multi-line address
Is this your first floating sound bath?
Yes
No
Health information Please tick all that apply.
Have you had or been suffering from any of the following in the last five days? Please tick all that apply:

Please be advised if you have ticked any of the above (excluding the none of the above box), you will need to get in contact with The Well-being Hub via the contacts page, as you will not be allowed to particpate in the upcoming event if it is in five days or less. This is for your safety and wellness as well as others.

what is your swimming ability?
Non swimmer
Can swim but not confident
Confident swimmer
The next three questions are to assess and provide appropriate floatation mat selection for each participant. Please advise your weight group in this question. NO INFORMATION IN THIS FORM WILL NOT BE SHARED. It is for participant safety purposes only

If you have ticked the above 22st (139.5KG+) box, please note the floatation mats are unable support you safely. You are welcome to attend as a participant on the side of the pool, please contact us via the contact page so we can make suitable arrangments and adjustments.

What is your height?

Please note our floats are 199cm in length. If you are over 6ft 4in (190cm) you may slightly be off the end of the mat, however you are welcome to particpate. Please contact via the contact page if you have any questions or concerns.

Please advise your body type:

*The information you have provided above is for your safety and comfort during the floating sound bath. We thank you for taking the time to complete the above sensitive information as it enables us to maintain the highest standards and safety regulations. If you are above 22St/139.5KG and also over 6ft2in and in thr XL catergory, please contact us so we can discuss your needs in line with our safety policies.

I agree to the following statement (tick boxes once read to indicate you agree):

Floating Sound Bath Rules:


1: Safety First: The safety of all participants is of the upmost priority of us. Please follow all guidance and rules to ensure the safety and wellbeing of yourself and others. 


2. Stay on the Float: Participants must remain on their designated float throughout the session. Please do not deliberately rock the float, cause waves in the water, purposely collide with, or push away another float or your own. Movement on the float increases the chances of falling in. If you require assistance or to come off your float please raise your hand and a safety officer will attend to you.


3. Listen to the facilitator: Follow all instructions and guidance provided by the sound bath facilitator or safety officer at all times.


4. Respect Others: We ask participants to maintain quiet and be respectful to allow all participants to fully experience the sound bath. Please avoid unnecessary talking or disruptive behaviour during the session.


5. No Running or Jumping: To prevent accidents or injuries, do not run around the pool area or jump from the float. You will be assisted on and off the float.


6. Alcohol and Drugs: The consumption of alcohol or drugs before or during the floating sound bath session is strictly prohibited and this includes anywhere within the vacinty of the pool/property.


7. Personal Belongings: Securely store all personal belongings in a bag to prevent them from getting wet or lost. Personal belongings can be taking to the back wall of the pool area and left safely there whilst you participate in the floating sound bath. All personal belongings are left at owners risk. The Well-being Hub and their asssociates will not take repsonsibilty for your belonging.


8. Medical Conditions: Please inform on the day of any medical conditions, injuries, or concerns before participating in the floating sound bath that may affect you before, during or after the sound bath. Please consult with a healthcare professional where appropriate.


9. Hydration: Drink plenty of water before and after the session to stay hydrated, especially if the weather is warm and as you are attending an indoor venue. Please ensure you use bathroom facilities prior to session starting.


10. End of session: Wait for instructions and assistance on how to safely exit the water and return to the side of the pool after the floating sound bath session ends.


11. Leave no trace: Please take all your belongings and any rubbish home with you.


12. Some participants may fall asleep during the session or go into a deep meditative state. The staff and pool safety officers will be monitoring participants throughout the session to ensure safety is facilitated at all times.


13. If a participant is deemed to be in an unsafe position- for example they have moved on to their side or are on the edge of their float, they will be gently prompted, assisted and made safe. This may include stopping the session briefly.


14. Although unlikely, there is always the risk that a float may deflate. If this happens we will safely remove you from the pool and place you on to another float. All floats are safety checked before each sound bath session.


15. Swimming capability: You must be a competent swimmer and be able to swim and tread water. If you can not swim you cannot attend the session for saftey reasons. With discussion, you may be able to attend the session on the side of the pool on a lounger, this will be at the discretion of the sound practioner and/or safety officer following you contacting The Well-being Hub to discuss, at least 48 hours prior to a session commencing. Failure to comply to this rule will mean your instant removal from the session and property, and no refund will be issued


16. Clothing: We recommend you wear either a swimsuit or light weight clothing such as gym wear. You will get wet getting on and off the float up to your knees or even your thighs. The pool room is very warm and we recommend light clothing or a swimsuit. We provide towelette blankets. We do not guarantee your clothing will not get wet. Bring something to change into after the session.


• Please attend in your clothes that you will wear on the float. There are changing facilites for after, but attending in your swimwear/lightwear clothing will aid a smooth and prompt start to the session.


17. Contraindications to attending a floating sound bath:

Sound baths, which use sound frequencies and vibrations for therapeutic purposes, can be relaxing and beneficial for many people. However, there are some contraindications or situations where caution should be taken before participating in a sound bath or where attendance is not suitable.


Please contact your healthcare professional if unsure and then contact us. A refund will be provided if you are not medically suitable to attend:


a. Pregnancy: Please consult your health practitioner prior to attending. Laying on your back for extended periods is not advised. You have a higher risk of injury when getting in and out of the pool due to balance changes in pregnancy. 


b. History of Seizures: People with a history of epilepsy or seizures are not permitted to attend a sound bath as certain frequencies might trigger seizures.


c. Tinnitus or Hyperacusis: Those with severe tinnitus (ringing in the ears) or hyperacusis (sensitivity to sound) might find the sound bath uncomfortable or exacerbate their condition.


d. Mental Health Conditions: Individuals with severe mental health conditions or psychiatric disorders should consult with a healthcare professional before attending a sound bath.


e. Medical Devices: People with implanted medical devices such as pacemakers should consult with their healthcare provider to ensure that the sound frequencies used won't interfere with the device.


f. Recent Surgeries: Individuals who have had recent surgeries, especially those involving the head, neck, or ears, should consult with their healthcare provider before participating. Although unlikely, there is also a chance of recent scars or open wounds getting wet and the risk of infection can arise.


g. Chronic or Acute Medical Conditions: Those with chronic or acute medical conditions should consult with a healthcare provider to ensure that a sound bath is safe for them.


h. Medications: Some medications can cause dizziness or drowsiness please consult your medical practitioner prior to booking.


i.Hearing Loss: Individuals with significant hearing loss should be cautious as the vibrations may not be felt or heard in the intended therapeutic way.


j. Intolerance to Certain Frequencies of Sound: Some people might have a sensitivity or intolerance to specific sound frequencies, which could cause discomfort or anxiety.


k. Stomach bugs including but not limited to sickness and diarrohea, food posioning within the last 72 horus (minimum).


•Please note this is not an exhaustive list. If you have any of these conditions or other concerns, it is essential to consult with a healthcare provider before participating in a sound bath to ensure your safety and well-being.


Waiver and Liability Statement:

You agree to take responsibility for your own health and well-being, and property in relation to the activities that you undertake. To the maximum extent permitted by law, The Well-being Hub will accept no liability for any direct or indirect loss or damage, foreseeable or otherwise, this includes any indirect, consequential, special, or exemplary damages arising from the engagement in a floating sound bath activities at the venue in Welton Lincoln UK, whether in contract, tort, including negligence, breach of statutory duty or otherwise, arising under or in connection with The Well-being Hub and/or their associates . You agree to be responsible for your own property.


You agree to indemnify and keep indemnified The Well-being Hub, its owner, associates, employees, staff, coaches, safety officers,, and any other person or persons as may be authorised by The Well-being Hub to promote or organise these activities from and against all actions, claims, costs, expenses, and demands in, or connected with your failure to comply with any of your obligations as set out above. Nothing in this waiver shall limit or exclude our liability for death or personal injury resulting from our negligence or limit any of our liabilities in any way that is not permitted under applicable law, or exclude any of our liabilities that may not be excluded under applicable law.


By submitting this form, you acknowledge and confirm that you are over the age of 18, competent to sign (electrionically or otherwise) this waiver, and you have read the waiver and indemnity carefully, and understand the terms and conditions. Having read the waiver, you agree to provide the indemnity requested. You acknowledge that you have agreed to submit your acceptance to this waiver without any inducement, assurance, or guarantee and intend this signing submission to serve as confirmation of your complete and unconditional acceptance of the terms, conditions, and provisions of the waiver.

For further information or if you have any questions, please contact us:

E: hello@thewbh.co.uk

T: 07596329667

W: www.thewbh.co.uk


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