Request edit access
Yoga Agreement
I understand that yoga includes physical movements as well as an opportunity for meditation, relaxation, stress reduction and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated.

If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the instructor. I will continue to breathe deeply. I assume full responsibility for any and all damages, which may incur through participation. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate.

I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Lisa Hassett, CYT, &/or Reiki of Greater Boston. My signature further acknowledges that I shall not now or at any time in the future bring any legal action against he same and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns. My signature is binding to this liability waiver from this day forth.

I have read and fully understand and agree to the above terms of this Liability Waiver Agreement and am signing this agreement voluntarily.
Student Signature:
Your answer
Date:
MM
/
DD
/
YYYY
Date of Birth
MM
/
DD
/
YYYY
Email:
Your answer
Phone:
Your answer
Emergency Contact & Phone
Your answer
Reiki of Greater Boston - Healing for Body, Mind & Spirit
160 School Street, Suite 1-1, Waltham, MA 02451
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service