Yogabrary Monthly Subscription
Contact us at (916)548-7221 or alicia.k.patrice@gmail.com
Name *
Email *
Phone Number *
Do you have any injuries or conditions that are relevant to physical practice? *
I understand that I am committing to a monthly online video subscription and intend to pay promptly upon notice of payment requested. (You may cancel at any time.) *
Required
What is your preferred payment method? *
Required
By checking the box below, I acknowledge that yoga is a physical discipline that requires a certain amount of mental concentration and physical strength and endurance. I agree to work according to my own limitations; take full responsibility for my own safety and well-being; and release Alicia Patrice from any liability associated with her yoga instruction. Furthermore, I acknowledge that participation in yoga classes exposes me to a possible risk of personal injury. I am fully aware of this risk and hereby release Alicia Patrice from any and all liability, negligence, or other claims, arising from, or in any way connected, with my participation in yoga. My checking this box further acknowledges that I shall not now, or at any time in the future, bring any legal action against the above; and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns. My check mark verifies that I am physically fit to participate in yoga classes and a licensed medical doctor has not informed me that my physical condition prevents me from participating in this type of class. My signature is binding to this liability waiver from this day forth. *
Required
Do you have any questions?
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy