New Student Registration/ Liability Waiver
(Please print clearly.)
Your Name: _______________________________ Phone: ( ) _________________________________
Email Address ___________________________________ Birth Date ___/____/_______
Would you like to receive important emails about events & Workshops? YES or NO
Emergency Contact: _____________________ Relationship: _______________ Phone# ( ) ______________
How did you hear about Yoga Tree Studio? _______________________________________________________
How long have you been practicing yoga? ________________________________________________________
I, ____________________________________________, am seeking to participate in (the) Yoga Classes/Workshop/Retreat offered by Yoga Tree Studio, LLC, during which I will receive information and instruction about yoga and health. I understand that Yoga is a physical exercise and that Yoga classes consist of a series of postures (asanas) that bend, stretch and compress every part of the body. This practice stimulates glands, circulation, respiration and the nervous system. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity and ask for support from the instructor.
Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended, and is not safe, under certain medical conditions. I understand it is my responsibility to consult with a physician prior to, and regarding my participation in, Yoga Classes. I certify that I am physically fit and I have not medical condition, which would prevent my full participation in Yoga Classes. I will make the instructor aware of any medical conditions or physical limitations before every class. If I am pregnant, become pregnant or I am post-natal surgical, my signature verifies that I have my physician’s approval to participate.
I affirm that I alone am responsible to decide whether to practice yoga and understand that participation is at my own risk. I my heirs or my legal representatives, hereby agree to forever irrevocably release and waive any claims that I have now or may have hereafter against Yoga Tree Studio, LLC, its staff, employees, instructors and lease holders.
I have read and fully understand and agree to the above terms of this Liability Waiver Agreement and voluntarily agree to the terms and conditions above as a consideration for participation in Yoga Classes. I acknowledge and recognize that my signature serves as a complete and unconditional release of liability to the greatest extent allowed by law in the State of Florida
I further understand that from time to time, Yoga Tree Studio LLC., may produce still photographs and/or video recordings for marketing purpose. I hereby authorize Yoga Tree Studio LLC. or its assigns to use and reproduce any photographs, personal narrative, interviews or audio and video recording of my participation for any and all purposes, without compensation.
____________________________ ____________ _____________________________ ________________
Client Signature Date Staff Signature Date
*If you are under the age of 18, your parent/guardian must sign and return this form prior to attending Yoga Tree Studio (YTS) classes.