Name *
Name
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Address
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Phone
Name, telephone, relationship
I hereby agree to the following: (1) That I am participating in yoga classes during which I will receive information and instruction about yoga and health, and I will direct any questions to the instructor if I do not understand. I recognize that yoga requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. (2) That I will inform the instructor of any symptoms during my participation in the session as they occur, such as but not limited to fatigue, shortness of breath, chest discomfort, or any pain or discomfort, for my safety and benefit. (3) That it is my responsibility to consult with a physician prior to and regarding my participation in yoga. I represent and warrant that I am physically fit and have no medical condition that would prevent my participation in yoga instruction. (4) That the instructor present may sometimes perform physical adjustments during yoga sessions. If I do not want such adjustments, I will inform the instructor at the beginning of each session. (5) In consideration of participating in yoga sessions, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which I might incur as a result of participating in yoga instruction. (6) In further consideration of participating in yoga instruction, I, my heirs or legal representative knowingly, voluntarily and expressly waive any claim I may have against the instructor for any injuries or damages that I may sustain as a result of participation in yoga instruction. I have read the above release and waiver of liability and fully understand its contents. By submitting this form I voluntarily agree to the terms and conditions stated above. I am over 18 years of age.