Become a Shine Your Light Yoga Studio

Corporate name of studio *

Website address for studio *

Studio Owner's Full Name *

First Name Last Name

Studio Co-Owner's Full Name (if applicable)

First Name Last Name

Primary Contact (if different from above)

First Name Last Name

Title or position of primary contact *

Email Address of Primary Contact *

Confirmation Email example@example.com

Cell Phone of Primary Contact (US Country Code = +1; Canada Country Code = +1; Australia Country Code = +61; UK Country Code = +44; find other Country Codes at https://countrycode.org/) *

Country Code Area Code Phone Number

Office Phone of Studio (US Country Code = +1; Canada Country Code = +1; Australia Country Code = +61; UK Country Code = +44; find other Country Codes at https://countrycode.org/)

Country Code Area Code Phone Number

Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

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Secondary Contact Person (for backup) *

First Name Last Name

Secondary Person Email *

Confirmation Email example@example.com

Secondary Contact Person Cell Phone (US Country Code = +1; Canada Country Code = +1; Australia Country Code = +61; UK Country Code = +44; find other Country Codes at https://countrycode.org/) *

Country Code Area Code Phone Number

We encourage you to have regularly scheduled classes that are trauma-informed and would therefore qualify as Shine Your Light (TBTN) Classes. Please let us know your current or proposed schedule to create these safe spaces for survivors. Please list the class(es) you are designating as Shine Your Light Class(es). List each class with the date, start and end time, style of yoga, and class fee (which will be donated to TBTNF). *

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

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Please provide your LinkedIn account:

Please provide your Instagram account:

Please provide your group's social media handles for Twitter, Facebook, Instagram and any other platforms you use:

Terms and Conditions for Shine Your Light Yoga Studios

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

My yoga studio agrees to hold one or more Shine Your Light Yoga Class(es) (hereinafter, "Class(es)") on behalf of and in support of the Take Back The Night Foundation (hereinafter, TBTNF).

I agree to comply with the risk management requirements listed on the TBTNF website. I certify that my Studio has General Liability Insurance with at least $1,000,000 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 TBTNF; for any death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to myself, Class participants or volunteers as part of my Studio's involvement in these Class(es).

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 any Class. I agree that all funds raised in conjunction with any Class (including any donations or moneys taken in prior to, during and after any Class), 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 any Class 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 Class(es) on my Studio’s website, social media outlets, and/or marketing materials.

I agree any Class 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 Class(es).

STUDIO BENEFIT LEVELS

I understand that as a host studio complying with the above terms, I am permitted to use TBTNF's logo and moniker, Shine Your Light readings, TBTNF social media cards, and other resources, all in limited use for only these Class(es).

I understand that upon successful participation in these Class(es), including the Trauma Sensitive Yoga Studio Practices listed on the TBTNF website, and upon raising a minimum of $250.00 for 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.

Today's Date *

Date

Upload either a copy of your studio's insurance policy or a signed statement confirming you have insurance of at least $1,000,000 and the name of your insurance company. *

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