BLAQUE GIRL YOGA LIABILITY WAIVER AND RELEASE FORM

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𝐃𝐢𝐬𝐜𝐥𝐚𝐢𝐦𝐞𝐫

Blaque Girl Yoga provides yoga, meditation, and wellness services for general well-being and relaxation. These services are not a substitute for medical or psychological treatment. Participants are responsible for monitoring their own physical and mental well-being. If you have any existing medical conditions, injuries, or concerns, please consult with a healthcare provider before participating.

Blaque Girl Yoga does not guarantee any specific results from participation in yoga sessions, nor is it responsible for any adverse effects experienced. Participation is at your own discretion and risk.

𝐍𝐚𝐦𝐞: *

𝐃𝐚𝐭𝐞 𝐨𝐟 𝐁𝐢𝐫𝐭𝐡: *

𝐏𝐡𝐨𝐧𝐞 𝐧𝐮𝐦𝐛𝐞𝐫: *

𝐀𝐜𝐤𝐧𝐨𝐰𝐥𝐞𝐝𝐠𝐦𝐞𝐧𝐭 𝐨𝐟 𝐑𝐢𝐬𝐤 𝐚𝐧𝐝 𝐂𝐨𝐧𝐬𝐞𝐧𝐭 𝐭𝐨 𝐏𝐚𝐫𝐭𝐢𝐜𝐢𝐩𝐚𝐭𝐞 I, 𝐍𝐀𝐌𝐄𝐃 𝐀𝐁𝐎𝐕𝐄 (the “Participant”), acknowledge that I am voluntarily participating in yoga, meditation, and wellness activities offered by Blaque Girl Yoga. I understand that these activities may involve physical exertion and carry inherent risks, including but not limited to muscle soreness, injury, dizziness, or other physical discomforts. I certify that I am physically and mentally fit to participate and have consulted with a healthcare professional if necessary. *

Yes

𝐀𝐬𝐬𝐮𝐦𝐩𝐭𝐢𝐨𝐧 𝐨𝐟 𝐑𝐢𝐬𝐤 I assume all risks associated with my participation in Blaque Girl Yoga classes, workshops, and events, including but not limited to injuries, accidents, and health complications. I understand that Blaque Girl Yoga, its instructors, and affiliates are not medical professionals and that yoga practice should not replace medical advice or treatment. *

Yes

𝐂𝐎𝐕𝐈𝐃-𝟏𝟗 𝐀𝐬𝐬𝐮𝐦𝐩𝐭𝐢𝐨𝐧 𝐨𝐟 𝐑𝐢𝐬𝐤 and Agreement I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk of exposure by participating in Blaque Girl Yoga activities. I agree to follow all safety guidelines, including but not limited to social distancing, sanitization, and mask-wearing if required. I confirm that: • I am not experiencing COVID-19 symptoms. • I have not been in close contact with a confirmed COVID-19 case in the past 14 days. • I will not attend a session if I test positive for COVID-19 or feel unwell. I release Blaque Girl Yoga from any liability related to exposure, contraction, or spread of COVID-19. *

Yes

𝐑𝐞𝐥𝐞𝐚𝐬𝐞 𝐨𝐟 𝐋𝐢𝐚𝐛𝐢𝐥𝐢𝐭𝐲 In consideration of my participation, I hereby release, waive, and discharge Blaque Girl Yoga, its owner(s), instructors, employees, affiliates, and representatives from any and all liability, claims, demands, actions, or causes of action arising from my participation, including but not limited to personal injury, illness (including COVID-19), property damage, or loss. *

Yes

𝐍𝐨𝐧-𝐑𝐞𝐟𝐮𝐧𝐝𝐚𝐛𝐥𝐞 𝐏𝐨𝐥𝐢𝐜𝐲 I understand and agree that all payments for Blaque Girl Yoga classes, workshops, and events are non-refundable. If I am unable to attend, I may be eligible for a class credit at the discretion of Blaque Girl Yoga. No refunds will be provided for missed sessions due to personal reasons, including illness, scheduling conflicts, or late arrivals. *

Yes

𝐌𝐞𝐝𝐢𝐜𝐚𝐥 𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐀𝐮𝐭𝐡𝐨𝐫𝐢𝐳𝐚𝐭𝐢𝐨𝐧 In the event of a medical emergency, I authorize Blaque Girl Yoga staff or instructors to seek emergency medical care on my behalf. I understand that I am responsible for any costs associated with medical treatment. *

Yes

𝐀𝐠𝐫𝐞𝐞𝐦𝐞𝐧𝐭 𝐚𝐧𝐝 𝐒𝐢𝐠𝐧𝐚𝐭𝐮𝐫𝐞 I have read, understood, and voluntarily agree to the terms of this waiver and release. I acknowledge that by signing this form, I am waiving legal rights, including the right to sue. (𝐏𝐫𝐢𝐧𝐭𝐞𝐝 𝐧𝐚𝐦𝐞 𝐰𝐢𝐥𝐥 𝐛𝐞 𝐲𝐨𝐮𝐫 𝐬𝐢𝐠𝐧𝐚𝐭𝐮𝐫𝐞.) *

𝐏𝐚𝐫𝐞𝐧𝐭/𝐆𝐮𝐚𝐫𝐝𝐢𝐚𝐧 𝐒𝐢𝐠𝐧𝐚𝐭𝐮𝐫𝐞 (if under 18): *

𝐃𝐚𝐭𝐞 *

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