Waiver

NAME:__________

PHONE:__________

EMAIL:__________

DATE OF BIRTH:__________

ADDRESS:__________

ZIP CODE:__________

EMERGENCY CONTACT:__________

EMERGENCY CONTACT PHONE NUMBER:__________

If at any time during the class, you feel discomfort or strain, gently come out of the posture. You may rest at any time during the class. It is important in yoga to listen to your body, and respect its limits on any given day.

Agreement & Release of Liability

I, the undersigned, understand that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including yoga. I recognize that it is my responsibility to notify my teacher of any serious illness or injury before class. I will not perform any postures to the extent of strain or pain.

I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of class. Those under 18 years of age must have this form signed by a parent or guardian. 

I acknowledge that I have read this form and I fully understand its terms and conditions. I also understand that I am waiving and giving up my right to sue Ellensburg Yoga and its employees. By voluntarily signing this agreement I am committing this to be a complete and release of liability.

Name (print) __________

Signature __________

Date __________

Parent/Guardian __________

Signature __________

Date __________