YogaFaith Waiver

Name

Yoga Experience

Please List Any Medical Restrictions or Conditions (Type N/A if None)

Anything Specific You Are Looking to Gain From Yoga?

I HEREBY CONSENT AS A PARTICIPANT IN YOGAFAITH FROM ANY KNOWN OR UNKNOWN INJURY, ACCIDENT, OR HAZARD PREVIOUSLY, DURING, OR AFTER PARTICIPATION IN A YOGAFAITH SESSION. I CANNOT HOLD YOGAFAITH PERSONALLY RESPONSIBLE FOR ANY LIABILITY. (Initial Below)

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I RECOGNIZE THAT ANY FORM OF PHYSICAL ACTIVITY HAS A POTENTIAL RISK OF INJURY. I HEREBY AFFIRM THAT I AM PARTICIPATING IN A YOGAFAITH SESSION WITH KNOWLEDGE OF THE RISKS INVOLVED. I ASSUME AND ACCEPT ANY AND ALL RISKS OF INJURY AND HAZARDS. (Initial Below)

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I HEREBY AFFIRM MYSELF TO BE IN PHYSICAL CONDITION TO PARTICIPATE IN A YOGAFAITH SESSION WITH NO MEDICAL CONDITION OR INJURY PREVENTING ME FROM DOING SO. I HAVE DISCLOSED ALL MEDICAL RESTRICTIONS AND CONDITIONS THAT ARE RELEVANT TO PARTICIPATION. (Initial Below)

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Phone Number

Date

Month

Day

Year

Check here to acknowledge you have read and understood all of the above yoga class disclaimers.

Signature

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