Community Yoga~ Liability Waiver

Yoga Liability Waiver

Parent/Guardian Signature required if participant under the age of 18
Full Legal Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date of Birth
Phone Number

Area CodePhone Number
E-mail
Emergency Contact Name
Relationship to Emergency Contact
Emergency Contact Phone Number
Would you like to be added to my Newsletter? (I send a note on Substack about 1 x month) If yes, please make sure you have added your email above.

Yes!no, thanks
Waiver:

I understand that yoga is physically stressful and can be moderately dangerous for some people with health problems of which they may not be aware. I certify by my signature below that I have considered the state of my health and the risks associated with exercise and any activities performed with Grounded Here LLC or Andrea (Andy) Bachman. I understand that participating in yoga is voluntary. Therefore, I hold harmless and release Grounded Here LLC, Andrea (Andy) Bachman and the host site for class (Horse Time Center for Equine Collaboraration) from any and all liability, law or damages from any personal injury or emotional injury sustained from any connection with the above actives:

Cancelation Policy:

I agree to inform Andrea (Andy) Bachman within 24 hours of a scheduled session if there is a need for cancelation. That way your spot can be opened to another participant. If I give less than 24 hours notice, I agree to pay for the cost of the session in full.
Signature

Clear
Parent/Guardian Signature, if participant under the age of 18

Clear
Enter the message as it's shown*
Should be Empty:

Yoga Liability Waiver