Terms Of Registration:
It is our goal to make everyone’s visit(s) here a wonderful experience. Our caring staff members are committed to helping you achieve your goals and provide an atmosphere conducive to our integrative philosophy of addressing the whole individual (mind, body, and spirit). To aid in our commitment it is important that patients, clients, students and attendees cooperate with the following office/event policies. Thank You!
Payment
Whether paying with cash, check or credit card it is required that we have a valid credit card on file. If the credit card that you are using is that of someone else, their information (address, phone number, email, etc.) must also be included on our credit card form. The patient, client or customer in signing this form acknowledges that any unpaid balances or other money owed may be charged to this card if their account is not current. This includes charges for missed appointments. Payment for services are due either at the time services are provided or prior to that time depending on the program you have selected unless other arrangements are approved in advance by the office management in writing. Since we set aside 2 hours for most initial appointments, all new patient’s cards will be charged prior to that initial visit so that payment has posted by the date of that appointment. Excluding calls made for the sole purpose of scheduling an appointment(s) telephone calls/consultations lasting more than 5 minutes are billed as an appointment. Please make an appointment to discuss your case, review labs etc. (Provider’s time and knowledge are their stock and trade). Note: There is a $50.00 charge for checks returned un-payable for any reason or for credit card charges denied. This document authorizes BodySmart Wellness to bill your credit card.
Late, Missed and/or Changing Your Appointment
We attempt to see our patients/clients/customers on time. If someone is late for his or her appointment, the next patient, person is forced to wait past his or her scheduled time, therefore, 15 minutes late or more may be considered a missed appointment at the discretion of the provider. If for any appointment cancelled before 8:00 AM on the day of the scheduled appointment there will be charged $50.00 late cancellation fee. For any cancellations after 8:00 AM on the day of the scheduled appointment, the full fee for the visit will be charged. Your time is set aside specifically for you. As well, it is normally impossible for us to fill a cancellation on short notice so… please be on time for your appointment or you may be charged for the missed appointment (or lose a session if already paid for). We require 24 hours notice to change an appointment.
Refund Policy
All sales (programs, appointments, services, sessions, workshop, merchandise) are final. We will gladly replace any defective product with one identical or as close to identical as possible if it is brought to our attention within 48 hours. Unused portions of items such as supplements must be returned in the original container to receive a replacement or office credit at BodySmart Wellness’s discretion. Since success is a joint effort between the provider and the patient, client, student, or customer, we offer no guarantees stated or implied. We will do our part. If you follow instructions and do your part, success is the likely outcome.
Misc.
No unattended children under the age of 16 years old can be left unattended in the reception area or the outside halls. This is for liability reasons and as a courtesy to other patients, clients and students. Patients may not bring another person to share or piggy-back with their appointment. Anyone wishing services must schedule their own appointment.
As a courtesy to other patients clients, and students, and to maintain the serene atmosphere that we of striving for,absolutely no cell phone use is permitted in the office. If you must make or take a call, please step into the hallway.
Hold Harmless
Participants understand that martial arts, like any athletic activity has inherent risks. The participant with this document is given notice that the North American Wing Chun Association and Grandmaster Holder teach this system as a combat, fighting, practical self defense art.
In consideration being permitted to participate in classes or events offered by BodySmart Wellness and any of it’s subsidiaries, DBA’s or fictitious names, and/or including but not limited to, BodySmart Wellness, Grandmaster/ Dr. Philip Holder, Dr. Marie Kimelheim, The North American Wing Chun Association, Philip Holder, or any other of his/her/their/it’s Association / or organization, its officers, members, owners instructors, assistants, volunteers, landlords and/or employees and any division or affiliate of any of the above named, all hereafter referred to as the releesee(s), the person named above in this document, hereafter called the releaser, for himself/herself and personal representatives, heirs, students, associates and/or next of kin, releases, waives discharges and covenants not to sue the releasees, and releases them from all liability to the releaser, his/her personal representatives, assigns, heirs and next of kin for all loss or damage, and any claim or damage therefore, on account of injury to the person or any property or resulting in any loss or in the death of the releaser whether caused by negligence of releasees or otherwise while associated in any way with the releasees and programs. The releaser further agrees to accept full responsibility and liability for any guest of his/hers (student, employee or any other person) present or involved with any event, class or function involving the releasees.
The releaser agrees to indemnify the releasees and each of them from any loss, liability damage or cost releasers may incur due to the presence of the releasees in any releasee connected program at any location whether caused by negligence of the releasees or otherwise. Releaser hereby assumes full responsibility for any risk of bodily injury, death, or property damage due to the presence or negligence of the releasees or otherwise while attending a seminar, class, or other function, and/or while competing in, officiating in, working in, or for any purpose participating in or sponsoring any of the courses, classes or activities of the releasee at any of the releasee’s seminars or events inside or outside of the releasee’s main location or at the releasers location. Releaser expressly agrees that this release, waiver and indemnity agreement is intended to be as broad and inclusive as permitted by the laws of the State in which this agreement is executed as well as in the home state of BodySmart Wellness LLC. and that if any portion there of is held invalid, it is agreed that the balance shall, not withstanding, continue in full legal force and effect. In such an event, that any part of this agreement is not enforceable the releasor agrees that any recovery awarded to the releaser shall not be greater that the actual initial medical or physical damages incurred to the releaser. In no event can other damages such as, but not limited to, punitive damages, loss of time or loss of income, pain and suffering, be awarded.
I the releaser, being of lawful age, in consideration of being accepted (or as guardian in taking sole responsibility for the registration of a minor child) as a participant, for myself, my heirs, executors, administrators, and assigns, hereby release and forever discharge the releasee, instructors, officers and employees, helpers, their heirs, administrators, and executors from any and every claim, demand, action or right of action, or whatsoever kind of nature, either in law or equity arising from or by reason of any bodily injury or personal injuries known or unknown, death and/or property damage resulting in, or to result from any incident which may occur as a result of participation in any of the courses, classes, or activities at any event or any activities in connection with participating in any of the courses, classes or activities whether by negligence or not. I further release the releasees from any claim whatsoever on account of first aid, treatment or service rendered me during my participation in any of the courses, classes or activities instructed by the releasee. The releasor understands that by the nature of being a contact activity there is an inherent risk of injury or death and accepts full responsibility for his/her risk in full knowledge of this. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital. This Agreement will stay in effect for as long as the releaser is actively involved in events with the releasee and remains in effect even if the releaser withdraws and then returns at a future date. Releaser further states that he has carefully read the foregoing release and knows the contents thereof and signs this release as his own free act and holds harmless, indemnifies and agrees for his/her self and his/her heirs and assignees not to sue BodySmart Wellness LLC., Dr. Holder, Dr. Kimelheim and any staff or associates arising out of his/her participation & affirms that he/she is participating of his/her own free will. The registrant will be held responsible for any reasonable legal fees incurred by the provider in the collection of money owed or any damage caused to the provider financial or otherwise. If any part of this agreement is deemed unenforceable all other parts of this agreement remain in full effect.
IMPORTANT: It is prohibited for participants to bring recording devices into a BSW event. BodySmart Wellness reserves the right to discontinue services to anyone found doing so with no refund of fees paid or balance due. Also, phones must be completely turned off during any event. Interruptions caused by Clients/Patients/Customers etc. phones may result in the immediate ejection from the event
Dr. Holder and/or BodySmart Wellness reserves the right to record (audio/video) any sessions, events or consultations for our records. Any recordings become the sole property of Dr. Holder and/or BodySmart Wellness. Recordings may be used by the provider to review a case or for use in educational training media. With such recordings as well as all other patient client records, the client or patient’s identity will be protected and kept in confidence.