Laughter Session Registration Form

Laughter Session Registration

for Laughter Clubs, and Laughter, Breathing and Relaxation Workshops
Please read and sign this form prior to participating in a Laughter Yoga session(s) with Lotte Mikkelsen of UnitedMind Ltd, 128 City Road, London, EC1V 2NX.
Registration for

Business Experts ProgrammeIntroduction to Laughter TherapyLaughter Alone WorkshopLaughter One-on-One CoachingLaughter Yoga Basic SkillsThe 12 Chakra Laughter Activation ProgrammeLaughter Club
FOR LAUGHTER CLUB ONLY

This Laughter Yoga session(s) will take place on Zoom.

The link to the Laughter Club isOn Zoom meeting https://zoom.us/j/132683686 and password is provided with confirmation of your attendance.

Please do not share this link and password as all participants must read and sign this form before accessing the session(s).

This session is DONATION ONLY. If you wish to donate, there is no suggested amount.

We are all facing a challenging time, personally and professionally, so donation is completely voluntary.

A Laughter Club is just like a fitness session, if you would like to donate please follow the link https://paypal.me/unitedmind
Participant Information
Participant's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Mobile Number

Area CodePhone Number
E-mail
Do you have any allergies, chronic illness, or medical conditions? If yes, please describe.
Are you prescribed an inhaler? If yes, please explain any instructions.
Consent and Acknowledgement

I hereby accept liability for my participation in any and all activities facilitated by UnitedMind Ltd during the Laughter Yoga session(s). In exchange for the acceptance I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless UnitedMind Ltd. and all its respective officers, agents, and representatives from any and all liability for injuries arising out of traveling to, participating in, or returning from selected Laughter Yoga sessions.
Laughter Yoga Disclaimer

Laughter Yoga™ has many benefits for your mental and physical wellbeing. During laughter, we release endorphins which are the feel-good hormone that uplift our moods and help to combat stress. This release of hormones also boosts our immune systems. Laughter Yoga is based on the scientific fact that our brains cannot distinguish between real and fake laughter - so even if you don't feel like laughing, you can still reap many benefits from this session!

Laughter Yoga™ is not a substitute for proper medical consultation for physical, mental and psychological illnesses and may not be suitable for everyone. It is contra -indicated for people suffering from uncontrolled high blood pressure, heart disease, epilepsy, any kind of hernia, severe backache and major psychiatric disorders. This list is for guidance only and is not meant to be exhaustive. If in doubt do not try it and consult your trained medical professional for guidance. Anyone already undergoing physician-prescribed therapy should seek the advice of his or her doctor before reducing the dosage or stopping such treatment. Anyone experiencing discomfort while laughing, must discontinue immediately and seek expert medical help. Please use your common sense: no strain, no new pain.

UnitedMind Ltd as well as the people leading the Laughter Club you are participating in online today decline any responsibility from incidents resulting from the use (or mis-use) of the Laughter Yoga™ technique. It is your responsibility to pro-actively consult your trained physician for approval before participating in any Laughter Yoga session. By taking part in a Laughter Yoga session you accept full responsibility for your physical fitness and state that you are able to participate safely to the activity.

All Laughter Clubs in the UK are locally managed and fully independent from UnitedMind Ltd. We strongly encourage you NOT to participate or stop participating to activities you feel uncomfortable with.

Please Note: Your signature indicates that you have read and agree to the terms and conditions stated above and fully release the teachers / leaders of the Laughter Club you are attending today from any form of liability.

Please complete your name and electronic signature before joining this session. If you are signing for children aged 16 and under, please add their names into the comments box above.
Please check that you can agree with each question below.

IMPORTANT: This is an online session and normal first aid cannot be administered so please ensure you provide a contact number of someone who can immediately get to you and assist you.
There is no glass, china or other breakable material that may lead to injury

YesNo
For participants aged under 16, an appropriate adult (carer aged 18+) is present at the same time.

YesNo
If you are unable to follow the instructor’s instructions, you will cease the activity

YesNo
You have space to lie down or sit in comfortable chair where you can be safe and will not fall.

YesNo
You have a clear 2m space around you where you can raise your arms, jump, move about safely.

YesNo
Who to contact in case of emergency.
Name

First NameLast Name
Phone Number

Area CodePhone Number
Please note that these details will only be shared with the organiser of this event, who will also be attending the event.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty:

Laughter Session Registration

FOR LAUGHTER CLUB ONLY

Please check that you can agree with each question below.