XBody and Miha Bodytec EMS Training Waiver and Release Form

Please provide your electronic signature in the box below. Only training with electronic signature remain valid.


DECLARATIONS
- I declare to undergo XBody EMS training willingly and through my own responsibility. 
 - I declare that I am aware of the basics of the Electrical Muscle Stimulation (EMS) training method, including any and all circumstances which contraindicate the training, for instance, cases in which medical consultation is obligatory or advised and the further warnings and notes as is detailed on page 2 of this document.
- I declare myself to be able to undergo XBody EMS training with respect to my current mental state, health, and physical status. 
- I declare that I am not aware of any contraindication (described below) that may exclude me from the training. 
- I declare that I have received any and all obligatory medical consultations for the circumstances described below. 
- I declare that I will abide by the rules related to the preconditions, aftereffect and the training. 
- I declare to inform my physician and XBody Trainer in case of any change in my mental, physical and health status. 
- I declare to inform my doctor, or any other Medical professional involved in my care, in case of any medical intervention of undergoing the XBody EMS training. 
- I declare that in case of omitting or noncompliance with the terms of this agreement I undergo the training fully and completely through my own responsibility. 
- I declare that I will not hold XBody Hungary Kft. nor the XBody Trainer responsible if any of my unknown mental, health or physical conditions cause side effects or complications of any kind. 
- I declare that I will not hold XBody Hungary Kft. nor the XBody Trainer responsible in case of any side-effects, complications, lesions or any undesired change in my physical or health status. 
-  I understand that risks due to the long-term effects of EMS training are unknown, therefore I will not hold XBody Hungary Kft. nor the XBody Trainer responsible for any undesired effect. 
- I declare to follow the instructions given by the XBody Trainer before, during and after the training. 
-  Due to the necessity of close personal contact while putting on and removal of the Training Suit, I declare that in no way should this be misconstrued to be a sexual advancement or harassment of any kind. 
- I contribute that my personal and training data will be registered and used. 
I understand and accept to be bounded by the contents of all of the above-mentioned declarations. 

CONTRAINDICATIONS 
The XBody Newave USA is not intended to be used in conjunction with therapy or for treatment of any medical diseases or medical conditions. The usage in these cases are forbidden. IMPORTANT: DO NOT USE the XBody Newave USA device, if the client: Has implanted or external medical device (e.g. cardiac pacemaker, implanted defibrillator). Has severe cardiovascular diseases (e.g. severe heart or aortic disease). Has severe neurological disorder. Has medication-controlled or medication-uncontrolled seizures or convulsions (e.g. epilepsy). Has severe neuromuscular disorder (e.g. rhabdomyolysis or any disorder that affects the nervous system and the muscles and causes rapid breakdown in muscle structure). Has cancerous lesions (e.g. breast cancer). Has severe nephrological disease. Has existence or a tendency of internal bleeding. Has areas of skin that are inflamed, irritated, infected, wounded or oedematous. Is pregnant or suspects she may be pregnant. Has had any type of intensive training for two days after XBody WB-EMS Training, to avoid injury. 
RELATIVE CONTRAINDICATIONS 
In the following cases, medical consultation is obligatory. IMPORTANT: DO NOT USE XBody Newave USA WITHOUT CONSULTING a medical doctor if the client: Has metal implants. Make sure that electrodes are used in a way that it is impossible for electrical current to flow through the affected area (e.g. set intensities of such channels to 0). Has non-metallic or other implants (e.g. ceramic or silicone implants, gynecological, hormonal implants). Has less severe cardiovascular condition (e.g. hypertonia, high blood pressure). Had a recent surgical procedure, medical intervention or acute trauma. Has any type of hernia (e.g. abdominal or inguinal hernia). Has a chronic disease or fever. Has a contagious disease or any acute or chronic infections (bacterial or viral). Has diabetes. Has painful, sensitive skin or skin areas lacking normal sensation. Has menstrual cramps. Taking anticoagulant medication. Participates in any medical treatment (e.g. drug treatment). Participates in any drug or alcohol abuse treatment. Has any mental deficit (client can only use XBody Newave USA with guardianship). Has any other disease or unusual, abnormal physical condition or symptom. 
I understand and accept to be bounded by the contents of all the contraindications and relative contraindications. 
IMPORTANT NOTES 
Please read carefully the conditions listed below before starting your training with XBody WB-EMS technology: In case of malaise, ailment, dizziness or feeling aching tightness around the chest or heart area you must inform the trainer to immediately stop the training. If you feel any heat or discomfort on your skin during the training, you need to ask the trainer to switch off the device. There will be reflex-like muscle contraction movements caused by stimulation impulses. The trainer must inform the client to maintain pre-contracted muscles if possible. The client must acquire a stable basic position. Ensure to consume water before and after the training. If you feel necessary, have a short break during the training and drink a glass of water. Make sure that you had a proper meal 2-4 hours before your training. WB-EMS training might cause micro tears in the muscles, which usually leads to muscle soreness, and elevated creatine kinase (CK-MM) level in the blood. This is a natural reaction of the human body to intensive trainings (such as XBody WB-EMS trainings). In case you have your blood analyzed 2-6 days after your last WB-EMS training it is important to inform your doctor to prevent incorrect misinterpretation of your values. We, EMS HEALTH, LLC.,  collect your personal data (Name, E-mail, phone) due to your consent to identify and distinguish you from other clients. If you have any questions, contact XBody Hungary Kft. Service support for more information on telephone (+36-96-200- 183) or per email (helpdesk@xbodyworld.com). For further information visit our website: www.xbodyworld.com. 
I understand and accept to be bounded by the contents of the above mentioned.
Patient/Guardian Electronic Signature
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