This form covers any Chiropractic Services, Physiotherapy Services and Registered Massage Therapy Services offered offsite by health professionals from The Runner’s Academy. I agree to assume full responsibility for any risks, injuries, or damages, known or unknown, which I might incur or aggravate as a result of receiving treatment today. Any risks will be discussed with me by the health professional treating me, and I agree to inform the health professional of any limitations, physical discomfort and/or injuries prior to receiving therapy. In further consideration of being permitted to receive treatment offered by The Runner’s Academy, I knowingly, voluntarily and expressly waive any claim I may have against The Runner’s Academy for any injury or damages I may sustain as a result of participating in these services. All information obtained today for treatment or diagnosis is confidential except as required by law and to facilitate assessment of treatment