Liability Waiver & Consent to Receive Massage

 I understand that information I have provided to Misty Murray, LMT, d.b.a. Manifest Massage, is used for the sole purpose of determining the safest and most appropriate massage modality for my session. I have disclosed this information as accurately as possible and have not withheld information intentionally. I agree to inform Misty if I experience any pain, discomfort, sensitivity, or distress during my session, allowing her to make appropriate adjustments. I understand I may end the session at any time. I understand that this massage is for relaxation and relief from muscular tension, and is not a form of or replacement for medical care. I understand there is a risk of minor bruising, soreness, or lightheadedness immediately following a massage. I will not hold Misty responsible for adverse reactions to the massage or products, or for any injury sustained by accident during my visit.
 
I understand that this is a professional massage by a licensed massage therapist and not a sexual service. Sexual innuendo or solicitation will result in the immediate termination of the massage and may be reported to the police. I further understand that altered states caused by intoxication or recreational drug use will result in the denial or immediate termination of my session. If the massage is ended due to these circumstances, I am still responsible for payment in full.
 
By signing and submitting this form, I certify that I am at least 18 years of age and fully competent to give my consent to receive massage, that I have been given the opportunity to ask any questions I may have, and that those questions have been answered.