Activities & Use of Facilities - I, the undersigned, fully understand that yoga, or any practice/activity (the Activities) offered at Yoga Circle Collective Healing Lab, Inc. (the Studio), is educational, not a substitute for medical attention, examination, diagnosis, or treatment, and that I am solely responsible for my health, safety, and well-being while participating.

I, for myself, my heirs, and any personal representatives, hereby voluntarily release and agree to hold the Studio harmless from any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage, injury or loss to my person and/or property incurred while practicing yoga and/or participating in the Activities at any time or place, and/or that may otherwise arise in any way in connection with any services received from/at the Studio notwithstanding any such loss, injury or damage may have may have been caused by any act, or failure to act of or reason of the negligence of the Studio.

I do

I understand that this release discharges the Studio from any liability or claim that I, my heirs, or any personal representatives may have against the Studio with respect to any accidents, bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received while engaged in the Activities on or off the premises.

I do

Physical Conditions, Medications and Past Injuries - I understand that I should consult a physician prior to beginning the Activities, to make sure that I am in adequate physical and mental health to participate and that it is my responsibility to take on their advice.

I do

I agree that I will inform my instructor of any activity which I cannot perform safely and I will not perform any activity which I feel is likely to cause me to injure myself. I agree to hold the instructor harmless from any and all responsibility for any injury that I may sustain during or as a result of my participation in the Activities. This liability waiver and release extends to the yoga studio together with the owner, teachers, instructors, workshop presenters, independent contractors and staff.

I understand it is my responsibility to work at a level that will not cause damage or injury and to update the teacher on any conditions that I have now and that develop during the session.

Privacy Policy - The Studio respects the privacy of your personal information, consistent with the Personal Information Protection Act. We are collecting contact information on this form in order to communicate with you about the Activities for which you have registered and for any related events. We are collecting your health-related information so that we may best be able to assisting, supporting and teaching you in a safe and conscious manner.

Photography & Filming - I hereby understand that the Studio from time to time may photograph, video, or otherwise record classes or events occurring at the Studio and share those videos with students for learning purposes or place such photographs and videos on its Website, social media platform, or marketing materials. I hereby consent to the use of my image that may appear in any such photograph or video.

I acknowledge that I have read, understood and accept the above conditions.

I do

Name

First Name

Last Name

Date

YYYY

Next of kin / close friend in case of emergency:

Phone

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###

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Alternatively, you can download the document here to print and sign and hand in. Thank you!

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