I Acknowledge and Agree that I am here at Nibana for a Massage Service with Jen Sage and recognize that Jen Sage is the only responsible and liable person during my time at Nibana Salt & Wellness.

By signing this form, I acknowledge that I am aware of any risks involved from receiving a treatment from Jen Sage and entering onto the property of Nibana Salt & Wellness.

I voluntarily agree to assume any and all risks, and I release and hold harmless Nibana Salt & Wellness and Nicole-Jayne Aymes from any claims related thereto.

Any persons seeking the services of Jen Sage on the premises of Nibana Salt & Wellness release and wave all rights of liability and responsibility over Nibana Salt & Wellness and Nicola-Jayne Aymes.

I submit this form in agreement and acknowledgement of all mentioned above.

By submitting I agree that this is used as my signature.