YOGA LIABILITY WAIVER

Yoga Liability Waiver

First Name

Last Name

Date of Birth

Are you 16 years of age or older?

Yes

If no, please have a parent or guardian sign this form.

Do you have any access needs, pains, or injuries that you would like me to be aware of?

Pronouns

I declare that the info I’ve provided is accurate & complete.

I do hereby give my permission for my participation in yoga classes and sessions with instructor Zoe Sorrell. By checking this box, I acknowledge that I am in good health and able to participate. I have no medical condition which would prevent my full participation and I understand that it is my responsibility to consult with a physician before my participation in yoga classes. If I have done so, I have taken the physician’s advice. I acknowledge that it is my responsibility to inform my yoga instructor of any pre-existing medical conditions or injuries that may impact my practice. In consideration of the permission granted to me to participate in yoga classes, I do hereby agree, on my own behalf, to release Zoe Sorrell from any and all actions, claims, and/or damages resulting in personal injuries and disabilities (physical and/or psychological) which are incurred by, arise from, or in any way relate to my participation in this yoga class. I realize that I am participating in yoga instruction at my own risk. My signature is binding to this liability waiver from this day forth. I acknowledge that I have carefully read this agreement and fully understand its contents. I voluntarily and knowingly agree to the terms and conditions stated herein. I execute the release voluntarily and with full knowledge of its significance and consequences.

Your Signature

Parent/Guardian Signature

Today's Date

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