RB Yoga Waiver
Waiver and Release Form
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Full Name *
Date of Birth *
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I hereby agree to the following: 1. I am participating in classes or services, either virtually or in person, during which I will receive information and instruction about yoga and health. I recognize that yoga requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. 2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any physical fitness program, including yoga. I represent and warrant that I have no medical condition that would prevent my participation in physical fitness activities. 3. In consideration of being permitted to participate in the yoga classes, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which I might incur as a result of participating in the program. 4. In further consideration of being permitted to participate in the yoga classes, I knowingly, voluntarily, and expressly waive any claim I may have against Rachel Barker should injury occur and I will also assume full responsibility for any injuries that may result from my participation. I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above by typing my name below: *
I agree that it is within my rights, and within Rachel's rights, to refuse any instruction given. I also agree to communicate with Rachel any questions and/or needs that I may have, by initialing below: *
My emergency contact person (name and phone number): *
Any injuries you'd like Rachel to know about?
Any favorite poses or yoga experiences you'd like Rachel to know about?
I ... *
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