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Yoga Student Release and Information Forms
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Luci

Forum Posts: 23
Member Since:
April 27, 2015
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1
April 13, 2010 - 3:29 pm
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Namaskar!

I never thought yoga liability forms could be so exciting.

Below is another variation.

One thing: I've never ever seen a student injured in any yoga classes, but we don't spank, kick, or jump on them either. <img decoding=" title="Laughing" />

Shanti,

Tomako


AGREEMENT OF RELEASE AND WAIVER OF LIABILITY
NAME: ___________________________________________________________________________
STREET: _________________________________________________________________________
CITY: _________________________________ STATE: __________ ZIP CODE: _______________
HOME PHONE: __________________OFFICE: __________________ CELL:___________________
HOW DID YOU HEAR ABOUT US ? _________________________________________________________
E-MAIL ADDRESS :_______________________________________________________________________________
Please list any physical conditions or disabilities, current or chronic, any medication taken at this time or any allergies. This information will help the instructor modify and tailor poses for your comfort and safety.
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I, ______________________________________, hereby agree to the following:
1. That I am participating in the Yoga Classes offered by Yoga School during which I will receive information and instruction about Yoga and health. I recognize that Yoga involves physical exertion which my be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Yoga Class. I represent and warrant that I am physically fit and I have no medical condition which would prevent my full participation in the Yoga Class.
3. In consideration of being permitted to participate in the Yoga Class, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program.
4. In further consideration of being permitted to participate in the Yoga Class, I knowingly, voluntarily and expressly waive any claim I may have against Yoga School / Yoga Teacher for injury or damages that I may sustain as a result of participating in the program.
5. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue for any injury or death caused by their negligence or other acts.
I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.
Signature _________________________________________________________________ Date ________________
As Legal Guardian of______________________________________________________, I consent to the above terms and conditions.
Signature of Parent/Legal Guardian _________________________________________Date: __________________

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