Justine Yoga + Meditation Zoom Registration & Release and Waiver of Liability
Please fill out this registration form and release and waiver of liability. Then Venmo @justinefanarof or Zelle justinekerri@gmail.com to reserve your space. Thank you!
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First Name *
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Private Students: Please describe what your intentions are for your practice and our work together.
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Release And Waiver Of Liability: I am participating in yoga classes, health programs, workshops and/or other wellness, body work, therapy, exercise and healing arts activities (collectively, the “Activities”) offered by Justine Fanarof (“Teacher”). The Activities may be offered in a physical location or offered online by Zoom, videos, television, podcasts, apps or other digital media or platforms. All of such offerings, either physical or online, shall be considered “Activities.” I recognize that I must be in adequate physical and mental health to participate in the Activities. I understand that the Activities may require varied levels of physical exertion, and I represent and warrant that I am physically fit enough to participate in the Activities and I have no medical condition which would prevent my full participation in the Activities. I recognize the Activities may cause or aggravate a physical injury or medical condition. I understand that it is my responsibility to consult with a physician before my participation in the Activities. If I have done so, I have taken the physician’s advice. I understand the Teacher reserves the right to refuse my participation in any Activity on medical, fitness or any other grounds. I am aware that my participation in the Activities could result in a range of health conditions, including but not limited to, high blood pressure, fainting, heartbeat disorders, physical injury, heart attack or stroke and the Activities may aggravate pre-existing injuries. I understand that I could experience muscle, back, neck and other injuries as a result of my participation in the Activities. I UNDERSTAND MY PHYSICAL LIMITATIONS AND I AM SUFFICIENTLY SELF-AWARE TO STOP OR MODIFY MY PARTICIPATION IN ANY ACTIVITY BEFORE I BECOME INJURED OR AGGRAVATE A PRE-EXISTING INJURY. In further consideration of being permitted to participate in the Activities, 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 Activities, including those which may result from the negligence of the Teacher. In further consideration of being permitted to participate in the Activities, I knowingly, voluntarily and expressly waive any “Claim” (as defined below) I may have against the Teacher (“Released Party”) that I may sustain as a result of participating in the Activities (either online or in person) (“Studio”) even if the Claim arises from the negligence of Released Party or anyone else.Indemnification. I agree to indemnify and hold harmless Released Party from any loss, cost, or liability incurred in defending any Claim made by me or anyone making a Claim on my behalf, even if the Claim is alleged to or did result from the negligence of Released Party or anyone else. “Claim” includes but is not limited to any and all liabilities, claims, demands, expenses, fees, legal actions, rights of actions for damages, personal injury, mental suffering and distress, or death that I may suffer, my spouse, children or unborn child may suffer (including any legal fees or expenses) in connection with participation in any Activity. Release. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue Released Party for any Claim caused by any negligence or other acts of Released Party. Social Media/Photo Consent. I hereby understand the Teacher from time to time may photograph, video, or otherwise record Activities and place such photographs and videos on their website, social media and other photos sharing platforms. I hereby consent to the use of my image that may appear in any such photograph or video. Jurisdiction. This agreement shall be construed in accordance with, and governed by, the laws of the State of Texas. Conflict Resolution.  The parties agree if they have any disagreement arising out of or relating to this Agreement they will talk about it and work collaboratively and in good faith to resolve. If a dispute arises that requires a neutral, the Parties agree to negotiate in good faith a prompt and binding mediation process in Harris County, Texas. Severability. If any provision of this agreement shall be held invalid, illegal or unenforceable, it shall not affect any other provision of this agreement and this agreement shall be construed as if such provision had never been contained herein. *
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