Orest Wellness
Waiver of Liability/Assumption of Risk
Sign in to Google to save your progress. Learn more
I, the undersigned, wish to voluntarily participate in a yoga class taught through Orest Wellness LLC.  I understand that participating in this class presents many risks of bodily injury including, but not limited to, illness, strains, sprains, fracture, cuts, bruises, dislocations and other possible serious bodily injury. To the best of my knowledge, I am in good health and suffer no disability or condition which renders my participation in this activity medically inadvisable. I consent to the administration of emergency medical treatment on my behalf.  I understand that Orest Wellness LLC is not responsible for the payment of any medical attention I require as a result of my participation in this activity.  I agree to be responsible for expenses associated with such care. I hereby release, relieve, and hold harmless Orest Wellness LLC from any liability arising out of my participation in this activity. This waiver is not intended to release liability arising from the sole negligence of Orest Wellness LLC.
By signing below, I acknowledge that I have read this agreement, understand it, and agree to abide by it. This waiver includes any participants in my household. Participants under the age of eighteen years old must include the signature of a parent/guardian. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report