Breathing Workshop Sign-up
When: Sunday, June 24th, 3:00 - 5:00 pm
Where: 5 Elements Martial Arts
Cost: $35 before June 17th
What to bring: Yoga Mat, 2 Pillows, & a Blanket
How did you hear about the workshop? *
Email Address *
Your answer
Phone Number *
Your answer
Waiver Terms & Conditions
I understand that the practice and participation in tai chi, yoga, fitness training, martial arts, and/or self-defense may require vigorous physical activity and involves the risk of personal injury;

Having recognized the same, the undersigned hereby acknowledges awareness of the risks therein, and does certify that s/he is physically capable of performing the same, has not been otherwise informed by a physician or other healthcare provider, and knows of no restrictions that would prohibit or prevent him/her from participating in the practice and training of these programs.

Therefore the undersigned assumes all risks in connection therewith for any injury, harm, or damage that may occur to his/her self while engaged, and does fully release and hold harmless, 5 Elements Martial Arts & Wellness Center LLC, or any agent, employee, representative, independent contractor, singly and collectively, from any and all claims, liability, damages, or causes of action by the undersigned and his/her family, heirs, estate or assigns as the result of any injury, harm or damage sustained at any time hereafter as a result of his/her participation in the practice and training of the aforementioned programs.

I Agree to these Conditions *
Checking this box constitutes as your signature.
Name *
Your answer
Today's Date *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms