Sattva Space Yoga Waiver and Release of Liability Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Client First and Last Name: *

Client Birthdate *

YYYY

Client Address: *

Client Cell #: *

Client Email: *

Emergency Contact Name & Phone Number: *

Which of the following describes your yoga practice? *

I have never practiced yoga and am excited to begin

I have been practicing inconsistently for a few months

I have practiced inconsistently for 1-3 years

I have practiced consistently for 1 or more years

I have a daily practice

I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education, and relief of muscular tension. *

Yes

As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. Even if we are mindful, I acknowledge that there is a risk of injury associated with doing yoga. *

Yes

I affirm that I alone am responsible to decide whether to practice yoga and participation is at my own risk. *

Yes

I assume full responsibility for any and all damages that may occur through participation. *

Yes

If I experience any pain or discomfort, or if a pose feels unsafe, I will listen to my body and discontinue the activity and ask for support from the instructor. *

Yes

I acknowledge that yoga is amazing, although it is not a substitute for a medical diagnosis and treatment under the care of a licensed physician. *

Yes

People with certain medical conditions should not do certain poses. By signing I affirm that I have consulted with a licensed physician who has verified my good health and physical condition to participate in such a a fitness program. *

Yes

I have read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am signing this agreement voluntarily and recognize that typing my name below serves as signature that serves as complete and unconditional release of all liability to the extent of the law in the State of California of Sattva Yoga Studio and its teachers from any and all damages that may occur through participation. *

Yes

Typing your full, legal name below will act as your signature agreeing to the terms in this waiver and release of liability form: *

Date *

YYYY

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms