WAIVER AGGREMENT
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Email *
NAME (First & Last Name) *
DATE:
MM
/
DD
/
YYYY
ADDRESS:
PHONE: *
Where did you find me? (Social media, friend, google) *
Why did you register for the class? (increase flexibility, strengthening, lose weight)
HEALTH GOALS: *
ANY INJURIES *
WHAT ARE YOUR EXPECTATIONS *
YOGA EXPERIENCE? *
Can we send you our FREE e-book to download on Mindful Eating and tools to help?   Along with future promotional and emails. We promise not to bombard your email.
I understand and agree to the following:  I am participating in yoga classes during which I will receive information and instruction about yoga and mindfulness, as well as health. I recognize that yoga and mindfulness requires physical exertion, which may be strenuous and may cause physical injury and I am fully aware of the risks.   YES- agree   NO- don't agree *
Required
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in yoga and mindfulness classes.                                        YES- agree   NO- don't agree *
Required
I agree to assume full responsibility for any risks, injuries or damages, known, or unknown, which I might incur as a result of participating in yoga/mindfulness or any other activities. YES- agree   NO- don't agree *
Required
I knowingly and expressly waive any claim I may have against Curly Q Yoga, LLC  for injuries or damages that I may sustain as a result of participating in yoga class/bootcamp/private/small group sessions.  YES- agree   NO- don't agree *
Required
Check for permission for photo release and/or video recording. *
Required
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. *
Required
NAME( PRINT) in agreement *
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