Yoga Next Door Online Activity Waiver
All participants must answer the following questionnaire indicating medical conditions or concerns prior to engaging in the activity. If you are unsure about your physical ability to take part in yoga class because of a physical condition, consult your physician before enrolling, and please speak to the instructor before engaging in the practice.

The practice of yoga, like any physical activity or sport, involves the inherent risk of injury. For that reason, all participants are required to electronically sign this waiver, releasing the instructor, Yoga Next Door and Yoga At Your Door of any and all responsibility of injury to the participant. The undersigned hereby acknowledges that s/he understands the implications of signing the waiver and willingly accepts responsibility for any strains or injuries that could occur during or as a result of participation in a yoga class with Jessica Petrie and Yoga Next Door/Yoga At Your Door.
Email address *
First & Last Name *
Birthdate *
Address *
Would like to be added to the email list? *
Yoga Experience Level *
List any injuries, past or present, which you feel the instructor should be aware of: *
I am aware that my participation in this activity can result in injuries or health issues which may include but are not limited to bones, joints, ligaments, muscles, tendons, spine and other aspects of the skeletal system, as well as internal organs, vertigo, and general health and well being. I understand these risks and realize that I am responsible for any and all injuries that may occur during or as a result of engaging in this activity. I will not hold the instructor or her company liable in any way should I incur an injury or impairment as a result of practicing yoga. Please provide an electronic signature below. *
Date *
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A copy of your responses will be emailed to the address you provided.
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