CLIENT
CONSENT
- EMS training is not recommended for persons under the age of 16.
- Because physical exercise can be strenuous and subject to risk of injury, we urge you to obtain a physical examination from a doctor before using any exercise equipment or participating in any physical activity. Medical clearance is obligatory for older adults (50+ years). You agree that by participating in physical exercise or training activities, you do so entirely at your own risk.
- You are responsible for exercising within your limits and seeking medical advice and attention as appropriate.
- Any recommendation for changes in diet including the use of food supplements, weight reduction and/or body building enhancement products are entirely your responsibility, and you should consult a physician prior to undergoing any dietary or food supplement changes.
- During EMS (electro muscle stimulation) training the muscles are being stimulated by electrodes using low-frequency electric currents; this means that the limbs (arms and legs) must be contracted before the electric impulse.
- Please inform your doctor if you are planning to have a blood test 2-6 days after your last EMS training, in order to prevent misinterpretation of test results; high Creatine Kinase values may occur during and after EMS training.
- Please inform your trainer immediately if any of the following occurs:
- If you have any form of skin injury (e.g. wounds, inflammations, burns, itchy skin, eczema etc.), the electrodes cannot be placed on or close to injuries!
- If you feel that your skin starts to burn during the training, the training needs to be stopped immediately and the machine must be turned off!
- If you experience malaise, dizziness/faintness, chest pains or any other physical discomfort during the training, the training needs to be stopped immediately!
- Contraindications - EMS must NOT be used with the following medical conditions, or can only be used after approval by a medical practitioner:
- Abdominal wall or inguinal hernia
- Acute bacterial or viral infections
- Advanced arteriosclerosis
- Advanced Muscular Dystrophy
- Amyotrophic lateral sclerosis
- Any form of heart disease
- Arthritis
- Asthma or any form of lung disease
- Bleeding (haemorrhage), impaired clotting ability (haemophilia)
- Cancer
- Cardiac pacemaker and other metal implants
- Diabetes mellitus
- Electrolyte imbalance (hypokalemia)
- Fever
- Heart rhythm disorders
- High Creatine Kinase enzyme values (hypothyroidism, uremia)
- Hypertension and uncontrolled hypertension (200/105)
- Marfan syndrome
- Multiple Sclerosis
- Parkinson's Disease
- Pregnancy or breastfeeding
- Psychiatric disease (e.g. schizophrenia)
- Serious neurological diseases
- Severe arterial blood circulation disorders
- Skin Intolerance
- Slipped/ruptured spinal disk (herniated disk)
- Soft tissue swelling, Oedema
- Spastic epilepsy
- Spastic spinal paralysis
- Thrombosis or thrombosis tendency
- Thyrotoxicosis (due to hyperthyroidism)
- Tuberculosis
- Tumours
- Uncontrolled myxedema (severe hypothyroidism)
By doing EMS, you would hereby have confirmed that you have read and understood the above, and DO NOT suffer from any of the illnesses or conditions listed above. Or, you declare that YOU DO suffer from one or more of the illnesses or conditions listed above, and that you have received medical approval to do EMS training.
You agree that you are voluntarily participating in these activities and in the use of these facilities and premises, and you assume full responsibility for all potential risks, including but not limited to injury, illness, loss of property or death.
By accepting this release, you acknowledge that you understand its content and that this release cannot be modified orally.