Kalpataru Yoga
Registration & Content - Release form
Legal Name *
First Name & Last Name
Spiritual Name (If any)
First Name & Last Name
Please Check (if applicable)
First Name & Last Name
Clear selection
I am attending the program:
Clear selection
Address *
Door No, Street Name, etc.,
City *
State *
Country *
I am 18 years old or above *
*NOTE: FOR PARTICIPANTS UNDER THE AGE OF 18 (MINOR), MINOR’S PARENT/LEGAL GUARDIAN MUST COMPLETE AND SIGN THIS FORM ON MINOR’S BEHALF.
Phone Number *
Area Code - Phone Number
E-mail *
*By providing your email address, you agree to receive emails from Nithyanandeshwar Devasthanam Trust and its affiliates, which may include, among other things, information on other classes/programs, promotions, newsletters, inspirational messages, and tips about the Vedic/Hindu tradition.
Language *
I agree not to photograph, video and/or audio record any part of the Program. *
Required
BY CHECKING THIS BOX, I CONFIRM THAT I HAVE READ AND UNDERSTAND THE ABOVE, AND VOLUNTARILY AGREE TO BINDING ARBITRATION. IN DOING SO, I VOLUNTARILY GIVE UP IMPORTANT CONSTITUTIONAL RIGHTS TO TRIAL AS WELL AS RIGHTS TO APPEAL. *
Required
BY CHECKING HERE, I AM CONSENTING TO THE USE OF MY ELECTRONIC SIGNATURE IN LIEU OF AN ORIGINAL SIGNATURE ON PAPER. *
Required
I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS ENTIRE AGREEMENT PRIOR TO SIGNING IT, AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASED PARTIES. *
Required
Signature (Legal Name) *
*NOTE: IF UNDER THE AGE OF 18, LEGAL GUARDIAN MUST SIGN
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