Recovery Lounge Waiver & Release

for participants over 18

Pilates on Palm LLC, DBA Foundry Collective SRQ • In-Store Compression Boot Sessions

Service: Recovery Lounge compression boot session (15-30 minutes)

1) Service Description (Non-Medical)

I understand this is a non-medical wellness service using pneumatic compression boots intended for temporary relief of leg fatigue and general relaxation. It is not diagnosis, treatment, or a substitute for medical care. If I have questions about my health, I will consult a licensed clinician.

2) Read Before You Book — Health Screening (assess YES or NO)

In the last 6 months or currently, have you had any of the following?
 (If YES to any, do not use the service without written clearance from your clinician.)

☐ YES ☐ NO History of deep vein thrombosis (DVT), blood clots, or pulmonary embolism

☐ YES ☐ NO Cardiovascular disease uncontrolled by medication (e.g., uncontrolled hypertension, heart failure)

☐ YES ☐ NO Recent surgery (within 6 weeks) or acute injury to the legs/feet

☐ YES ☐ NO Open wounds, active infection, severe varicose veins with skin changes, or active cellulitis

☐ YES ☐ NO Neuropathy with impaired sensation (e.g., advanced diabetic neuropathy)

☐ YES ☐ NO Pregnancy complications or medical advice to avoid compression

☐ YES ☐ NO Any other condition where your clinician advised against compression

If you answered YES to any item above, please speak with us and do not proceed today without clinician clearance.

3) Comfort & Use

  • Socks required. Pants should tuck inside boots.

  • Tell staff immediately if you feel pain, numbness, tingling, dizziness, shortness of breath, or discomfort; we will stop the session.

  • I may stop the session at any time for any reason.

4) Assumption of Risk

I understand there are inherent risks including temporary discomfort or pressure, skin irritation, lightheadedness, or rare adverse events. I voluntarily assume all risks associated with my participation.

5) Release of Liability (Ordinary Negligence Only; Florida)

To the fullest extent permitted by Florida law, I release and discharge Foundry Collective SRQ, its owners, contractors, employees, and agents from claims arising from ordinary negligence related to this service. This release does not waive claims for gross negligence or intentional misconduct.

6) Indemnification & Hold Harmless

Except to the extent caused by gross negligence or intentional misconduct of the released parties, I agree to indemnify and hold harmless Foundry Collective SRQ from claims or expenses arising out of my participation.

7) Photos/Video (optional)

Please choose one option regarding your photo/video consent in the form below.

8) Acknowledgment

I have read and understand this consent & waiver, had the opportunity to ask questions, and sign voluntarily.