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Minor Liability Release

All persons under the age of 18 are required to have a parent or guardian fill out this form.

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Fill it in here if you like. Use Print or save as PDF to keep a copy. This page does not send the form anywhere.

Minor Liability Release

All persons under the age of 18 are required to have a parent or guardian fill out this form.

By signing below:

  • You are certifying that you are the parent or legal guardian of the minor receiving massage therapy treatment(s).
  • You understand that you may be required to remain at the facility for the entirety of the minor's treatment(s), may be required to assist the minor in preparing for treatment, and that we may ask you to remain in the treatment room to supervise all interactions between the therapist and the minor.
  • You have informed the massage therapist about all relevant medical history, symptoms, medications, and concerns associated with this minor.
  • You understand the scope of massage therapy and that it is not meant to diagnose, treat, or cure any conditions and is not a replacement for standard medical care. You give permission for your minor child to receive treatment(s) and agree to all the above terms.