I, the undersigned, agree that, before signing this consent form I have read the information below and understand the activity I am undertaking prior to participating in the massage (the Services).

Information about your activity

A clothed, seated neck, back and shoulder massage.

Terms and Conditions of the Services

When you participate in the massage, you agree to the following terms and conditions:

1. You are 18 years of age or older

2. You agree to communicate and behave in a respectful manner at all times

3. It is important that you are comfortable during the Services and that all activities are appropriate for you. If you have any health or other condition which may affect your participation in the Services, you must tell the facilitator before you begin. You understand you do not have to participate in the Services and can cease participation at any time

4. If the facilitator asks for specific information about your health or other matter that may affect your participation, you must answer truthfully. If you experience any adverse effects while participating in the Services (for example, if you feel unwell, have any pain or discomfort, or experience shortness of breath or dizziness) you must inform the facilitator immediately

5. The information or materials provided to you during the Services are a guide only (as they do not consider your personal circumstances) and are not a replacement for tailored and specific medical, healthcare or other professional advice

6. Bupa Wellness Pty Limited (Bupa Wellness) and its employees, agents, sub-contractors, directors and related bodies corporate will not be responsible for any injury, loss or damage you suffer from participating in the Services (except where liability cannot be excluded by law).

Privacy Statement

Bupa Wellness collects personal information from you during the Services. If you do not provide all of the information Bupa Wellness requests, we may be unable to provide the Services to you. Bupa Wellness may disclose your personal information to its employees, agents, sub- contractors or anyone we engage in providing the Services. We may also disclose your personal information to others if required or permitted by law. For example, if we reasonably believe that disclosing the information may lessen or prevent a serious and imminent threat to life, health or safety.

We may disclose your personal information to your employer for the purposes of booking your participation in the Services and confirming your attendance, and to administer the Services within your organisation. We may disclose information about your behaviour, wellbeing and conduct during and in relation to your participation in the services with respect to incidents that occur during or in relation to your participation in the services that impact the health and/or safety of you, the facilitators of the services and/or the participants participating in the services. We will not disclose any service outcomes, including information about your health to your employer. We will however disclose de-identified aggregated data resulting from the Services to your employer.

You have a right to request access to the personal information Bupa Wellness holds about you. You can request access to your information by contacting Bupa Wellness on 1300 881 580.

Bupa Wellness will handle your personal information as outlined in our Privacy Policy. This policy also contains information about how you can make a complaint about the handling of your information, and how you can request access to your information. You can view the policy by contacting Bupa Wellness on 1300 881 580 or by visiting https://bupawellness.com.au/terms/privacy_policy.html

Your Declaration

I have read and understood the Terms and Conditions and Privacy Statement and agree to participate in the Services on these terms.

I, the undersigned, agree that, before signing this consent form I have read the information below and understand the activity I am undertaking prior to participating in the massage (the Services).

Information about your activity

A clothed, seated neck, back and shoulder massage.

Terms and Conditions of the Services

When you participate in the massage, you agree to the following terms and conditions:

1. You are 18 years of age or older

2. You agree to communicate and behave in a respectful manner at all times

3. It is important that you are comfortable during the Services and that all activities are appropriate for you. If you have any health or other condition which may affect your participation in the Services, you must tell the facilitator before you begin. You understand you do not have to participate in the Services and can cease participation at any time

4. If the facilitator asks for specific information about your health or other matter that may affect your participation, you must answer truthfully. If you experience any adverse effects while participating in the Services (for example, if you feel unwell, have any pain or discomfort, or experience shortness of breath or dizziness) you must inform the facilitator immediately

5. The information or materials provided to you during the Services are a guide only (as they do not consider your personal circumstances) and are not a replacement for tailored and specific medical, healthcare or other professional advice

6. Bupa Wellness Pty Limited (Bupa Wellness) and its employees, agents, sub-contractors, directors and related bodies corporate will not be responsible for any injury, loss or damage you suffer from participating in the Services (except where liability cannot be excluded by law).

Privacy Statement

Bupa Wellness collects personal information from you during the Services. If you do not provide all of the information Bupa Wellness requests, we may be unable to provide the Services to you. Bupa Wellness may disclose your personal information to its employees, agents, sub- contractors or anyone we engage in providing the Services. We may also disclose your personal information to others if required or permitted by law. For example, if we reasonably believe that disclosing the information may lessen or prevent a serious and imminent threat to life, health or safety.

We may disclose your personal information to your employer for the purposes of booking your participation in the Services and confirming your attendance, and to administer the Services within your organisation. We may disclose information about your behaviour, wellbeing and conduct during and in relation to your participation in the services with respect to incidents that occur during or in relation to your participation in the services that impact the health and/or safety of you, the facilitators of the services and/or the participants participating in the services. We will not disclose any service outcomes, including information about your health to your employer. We will however disclose de-identified aggregated data resulting from the Services to your employer.

You have a right to request access to the personal information Bupa Wellness holds about you. You can request access to your information by contacting Bupa Wellness on 1300 881 580.

Bupa Wellness will handle your personal information as outlined in our Privacy Policy. This policy also contains information about how you can make a complaint about the handling of your information, and how you can request access to your information. You can view the policy by contacting Bupa Wellness on 1300 881 580 or by visiting https://bupawellness.com.au/terms/privacy_policy.html

Your Declaration

I have read and understood the Terms and Conditions and Privacy Statement and agree to participate in the Services on these terms.