NEW CLIENT FORM
WAIVER

If you have any physical/medical issues or injuries, it is your responsibility to inform your physician and the instructor before beginning class. Also, please let your teacher know if you prefer not to be touched. When performing the exercises, DO NOT STRAIN OR FORCE YOURSELF BEYOND YOUR NATURAL ability.

Waiver: In consideration of being permitted to participate in any way in the classes and services offered at Svasti Yoga, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue Svasti Yoga LLC, its officers, employees, agents, and sublessees from liability from any and all claims resulting in personal injury, accidents or illnesses, and property loss directly or indirectly arising from my participation in the classes and services offered at Svasti Yoga. I agree to hold Svasti Yoga LLC, harmless and indemnify it for any incident(s) arising from my use of classes, services, products and equipment offered at Svasti Yoga.

Acknowledgement of Understanding: I have read this waiver of liability, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am entering the agreement freely and voluntarily, and intend a complete and unconditional release of all liability to the greatest extent allowed by law.

Waiver Acknowledgement *
First name *
Your answer
Legal Name (if different)
Your answer
Last name *
Your answer
Birthdate *
Your answer
Email
(opt in if it is ok for us to send you emails)
Your answer
Pronouns
Your answer
Emergency Contact Name & Phone *
Your answer
Please list any sugeries, injuries, illnesses, & health concerns past & present.
Please include pregnancy, hypertension, heart disease, or aches, pains including sciatic pain!
Your answer
Please tell us about your experience with yoga & what you are hoping to get out of classes.
Your answer
How did you hear about us?
Your answer
*
Name & age of minor permitted to receive yoga or wellness services
(if signing for a minor)
Your answer
Your signature and today's date *
Your answer
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