COVID-19 Screening & Practice Waiver
Please complete this form prior to arriving for class!
Email address *
First & Last Name *
Today's Date: *
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Are you, or anyone in your household/immediate circle, experiencing any of the following? *
Yes
No
A current diagnosis of COVID-19, or any other communicable disease?
Awaiting on test results for COVID-19?
Symptomatic but unable to get tested for COVID-19?
A recent diagnosis of COVID-19, less than 10 days ago?
In the last 14 days, have you (or any member of the household/immediate circle) had any of the following? *
Yes
No
A fever over 99.6 degrees Farenheit?
Coughing, shortness of breath or difficulty breathing?
Loss of sense of smell or taste?
Tightness, pressure or pain in the chest?
I agree to contact Solstice Yoga Shala immediately if I develop symptoms or have a confirmed case of COVID-19 within 14 days after I have attended a class. *
Required
At Solstice Yoga Shala, we adhere to consistent sterilization and cleanliness practices. However, it is always possible to contract COVID-19 (or any other communicable disease) in any public space. While we are following recommended state, federal, and Yoga Alliance guidelines, we cannot 100% guarantee you will be free from exposure. That being said, exposure to communicable disease is unlikely but possible. Clicking "Yes" below indicates that the risks involved are understood, accepted, and that you consent to practicing in-studio at your own risk. *
Required
General Yoga Practice Waiver
I understand that yoga includes physical movement, strengthening, stretching, as well as an opportunity for relaxation, stress reduction and relief of muscular tension. If at any time during the class I feel discomfort or strain, I agree to gently come out of the posture. I understand that I may rest at any time during the class. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body and inform my teacher immediately. I, the undersigned, understand that this yoga practice is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is sometimes not recommended and is not safe under certain medical conditions. I should consult a physician prior to beginning any activity program, including yoga. I recognize that it is my responsibility to notify my teacher of pregnancy, any serious illness or injury before every yoga class. I affirm that I alone am responsible to decide whether to practice yoga. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Solstice Yoga Shala or any teacher affiliated with Solstice Yoga Shala. Those under 18 years of age must have this form completed by a parent or guardian. *
Required
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