TRAINING DETAILS - Please read this document. https://docs.google.com/document/d/1IqkCQGkpQEn6UqZ3snzslG6VtXgDuj_cAvsR54KzVrM/edit?usp=sharing . Contact Alexa at alexafd@gmail.com with your questions. *

Full Name (as you want it written on your final certificate) *

Full Mailing address *

email address *

Emergency Contact (Name, phone number, relation) *

Why am I taking this training? ( No previous experience required.)

If seeking CEU credits, please check which applies

My reasons for taking this course. What I hope to learn and how I imagine applying my Laughter Yoga knowledge and skills.

How did I find out about this training? *

Training Cost $425.00 (Certified Laughter Yoga Leader Training) Refresher Training $150.00 (for LY pros wishing to refresh their skills)

WAIVER/LIABILITY RELEASE Laughter Yoga (Hasya Yoga) is an aerobic exercise program which combines three powerful elements: 1. laughter exercises 2. deep breathing exercises (pranayama, no yoga poses). Movements may include gentle stretching, clapping, dancing and expression with improvisation during the laughter & breathing exercises. Participants are encouraged to go at their own pace and to be mindful of not creating any new pain. All exercises can be easily modified to the participant’s comfort level and can be performed seated (as in chair yoga) or standing. 3.We finish our session with a short, calming and centering mindfulness meditation.If in doubt, whether or not you can participate, please ask your doctor.No experience necessary. No yoga mats. Wear comfortable clothing and have a bottle of water handy. LAUGHTER YOGA WITH ALEXA, LLC www.laughteryogawithalexa.com P.O.BOX 105, MEDIA, PA 19063 alexa@laughteryogawithalexa.com 215 478 5669 Liability/Photo Release Laughter yoga is a fun and healthy exercise regime with beneficial effects for the body, mind and emotions. Like any form of aerobic exercise, it should not be practiced by people with medical problems without first seeking advice from their medical practitioner. Laughter yoga should not be considered as a substitute for proper medical consultation for physical, mental and psychological illnesses. It may not be suitable for everyone. Laughing involves some physical strain and a rise in intra-abdominal pressure. It is contraindicated for people suffering from: -Advanced (bleeding) piles -Any kind of hernia - Any persistent cough, flu like symptoms, COVID-19 - Anything with acute symptoms - Epilepsy - Heart disease - Untreated High blood pressure -Incontinence of urine - Major psychiatric disorders - Severe backache or having undergone surgery within the last 3 months. This list is for guidance only and is not meant to be exhaustive. If in doubt, first consult a trained medical professional for guidance. Anyone already undergoing physician-prescribed therapy should seek the advice of their doctor before reducing or stopping such treatment. I am participating in Laughter Yoga sessions requiring physical exertion that may be strenuous and may cause physical injury. I am fully aware of the risks and hazards involved. I am physically fit and I have no medical condition that would prevent my full participation in Laughter Yoga sessions, or if I have any medical problems or conditions I have fully revealed these to the Laughter Yoga leader before each session. 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 the sessions, and knowingly, voluntarily and expressly waive any claim I may have against Dr. Kataria School of Laughter Yoga, Laughter Yoga International, Laughter Yoga with Alexa, their leaders, teachers, employees or assistants for injury or damages that I may sustain as a result my participation. I agree that I, my heirs or legal representatives forever release waive, discharge and covenant not to sue for any injury or death caused by their negligence or other acts. I also grant permission for photos and videos taken during all the Laughter Yoga activities, which may be used for promotions for Laughter Yoga with Alexa. 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. *