Be a Shine Your Light Yoga Studio

Full Name *

First Name Last Name

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What is the website address (URL) for your studio? *

Email *

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Cell Phone *

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Office Phone *

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Address *

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Secondary Contact Person (for backup) *

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Secondary Person Email *

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Secondary Contact Person Cell Phone *

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Please list the class(es) you are designating as Shine Your Light Class(es) for Saturday, January 29, 2022. List each class with the start and end time, style of yoga, and class fee (that will be donated to TBTNF). *

Please upload a logo or other image for your studio. *

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Terms and Conditions for Being a Shine Your Light Yoga Studio

Please review and indicate your acceptance of the following terms by signing below.

I agree to serve as participating yoga studio for the Shine Your Light Yoga (hereinafter, “Event”) on Saturday, January 29, 2021 on behalf of and in support of the Take Back The Night Foundation (TBTNF). I understand this event may be postponed if an Act of God, such as Covid-19 or other national emergency occurs.

I agree to comply with the risk management requirements and terms for all TBTNF Events listed on the TBTNF website. I certify that my Studio has General Liability Insurance with at least $500,000 USD in coverage and will upload a copy below.

On behalf of myself and/or my Studio, I waive, release, and discharge from any and all liability, including but not limited to, liability arising from the negligence or fault of the TBTNF, Event attendees and sponsors; for any death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to myself, Event participants or volunteers as part of my Studio's involvement in this Event.

I agree to abide by the TBTNF Trademark Usage Terms and Conditions listed on the TBTNF Website.

I agree to represent and support the charitable mission of the TBTNF in organizing and holding this Event. I agree that all funds raised in conjunction with the Event (including any donations or moneys taken in prior to, during and after the Event), in the form of class fees, sponsorships, cash donations or other donations; will be given in their entirety to TBTNF. Failure to donate any funds received using the Shine Your Light Logo, Event Name or Take Back The Night Name may result in criminal and/or civil action.

I understand the operating costs related to hosting this Event are my responsibility, and I will in no way hold TBTNF responsible for any incurred expenses, including but not limited to instructor fees, cleaning or maintenance fees, wear and tear, or advertising costs.

I agree to have my Studio listed on TakeBackTheNight.org, TBTNF's social media and any other marketing promotions. I permit TBTNF to hyperlink my logo to my Studio’s website, Facebook profile or other site. I agree to submit our Studio’s logo and the web address of my studio with this agreement.

I agree to publicize the Event on my Studio’s website, social media outlets, and/or marketing materials.

I agree to submit the class(es) that will be designated as the Shine Your Light Yoga Class(es). I agree this class(es) will be free from physical contact and will include a reading of the brief opening and closing statement provided by TBTNF.

I agree to either use the TBTNF Donation Button on the TBTNF Website or mail all donations in the form of a US Money Order made payable to Take Back The Night Foundation to TBTNF not later than 5 business days after the Event.

I understand that if I cancel my participation in this Event, I will be responsible for making all accommodations for anyone who registered for the Event prior to my cancellation.

I understand that upon successful participation in this Event including the Trauma Sensitive Yoga Studio Practices listed on the TBTNF website, and upon raising a minimum of $250.00 for the TBTNF, I will receive the TBTNF “Survivor Support and Safety Seal" for one year's use to display on my studio's website, social media, and as a flyer at my studio.

I am at least 18 years of age and am acting in my capacity as a legal adult and a representative of my entity in signing and agreeing to the terms in this agreement. I have the authority to represent my entity in executing this agreement and have received the appropriate approvals from my entity to do so.

In signing this form submission, I hereby agree to these Participation Terms and Conditions.

Please read the terms and conditions above and respond below: *

I hereby agree to the Terms and Conditions for being a Shine Your Light Yoga Studio.

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Upload either a copy of your studio's insurance policy or a signed statement confirming you have insurance of at least $500,000 and the name of your insurance company. *

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Be a Shine Your Light Yoga Studio 2022