EmailMe Form - Elko Spas, Billiards & Pools Cold Plunge

Team Name *

What do you want your team to be called?

Team Captain Name *

First Last

Primary team contact person

Team Captain Email *

For event registration confirmation and information

Team Captain Phone Number *

### - ### - ####

In case we need to reach you quickly

Team Members *

Team Member 1
Team Member 2
Team Member 3
Team Member 4

List all team members' full names

Charity Name *

Which local charity are you supporting?

Charity Contact Name and Phone

How did you hear about this event?

Social Media

Word of Mouth

Email

Other (Please specify)

Liability Agreement and Waiver

PLEASE READ THIS DOCUMENT CAREFULLY. IT AFFECTS YOUR LEGAL RIGHTS.
By signing below, I acknowledge and agree as follows:
1. Acknowledgment of Risks
I understand that participating in contrast therapy — alternating between cold plunge immersion and hot tub soaking —
involves exposure to extreme temperatures that may cause physical stress including, but not limited to, dizziness,
fainting, cardiovascular strain, shock, or other injury or illness.
2. Medical Certification
I certify that I do NOT have any medical condition that could make this activity unsafe for me, including but not limited
to:
Heart disease or cardiovascular problems
High or low blood pressure
Respiratory conditions such as asthma or COPD
Circulatory disorders
Skin conditions aggravated by heat or cold
Pregnancy
Any other medical condition or physical limitation that would contraindicate hot or cold water immersion
I confirm I have consulted with my physician if I have any doubts about my ability to safely participate.
3. Voluntary Participation and Assumption of Risk
I freely and voluntarily choose to participate, assuming all risks, known or unknown, inherent in contrast therapy and
cold/hot water immersion.
4. Release and Waiver of Liability
I, on behalf of myself, my heirs, executors, administrators, and assigns, hereby waive, release, and discharge Elko Spas
Billiards and Pools, its owners, employees, agents, and affiliates from any and all liability for injury, illness, death, or
property damage resulting from my participation, including negligence or breach of any duty of care by Elko Spas
Billiards and Pools.
5. Indemnification
I agree to indemnify and hold harmless Elko Spas Billiards and Pools from any claims, damages, or causes of action
brought by me or on my behalf related to my participation.
6. Participant Responsibility
I agree to:
Follow all posted safety rules and instructions from staff.
Immediately inform staff if I experience any discomfort, pain, dizziness, or unusual symptoms.
Not use the cold plunge or hot tub if under the influence of alcohol, drugs, or medications that impair my abilities.
7. Emergency Procedures
I understand that Elko Spas Billiards and Pools has emergency protocols in place but is not responsible for any adverse
medical events or delays in emergency response.
8. Photo and Video Release
I consent to the use of photos/videos taken during my participation for marketing purposes.

By signing below, I certify that I have read, understood, and voluntarily agree to all terms of this waiver and release.

I Agree to the Terms Listed Above *

Signature

Clear

Are you 18 years of age or older? *

If you are under the age of 18, a parent or legal guardian must sign below to agree to the terms above on your behalf.

Parent or Legal Guardian Name

First Last

Date

MM / DD / YYYY

Signature of parent or legal guardian

Clear

By signing above, I tesstify that I am the parent or legal guardian of the participant listed above as team captain and I have read, understand, and voluntarily agree to all terms of this this waiver and release as it pertains to the participant listed on this form of whom I am the parent or legal guardian.