Language
English (US)
Spanish (Latin America)
Comeback Yoga Student Liability Waiver
I hereby agree to the following:
I understand that Comeback Yoga is a charity that is here to share knowledge and practice of yoga with its students. I understand my participation is entirely voluntary.
I understand that yoga is a physical activity and participation in yoga class includes, but is not limited to, participation in meditation techniques, yogic breathing techniques, and moving my body into various yoga postures.
I recognize that yoga, like any physical activity, requires physical exertion, which may be strenuous and may cause injury, even serious or disabling injury.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any physical fitness program, including yoga. I represent and warrant that I have no medical condition that would prevent my participation in physical fitness activities.
I understand the practice of yoga may include physical assists or adjustments of the students by the teachers. I understand it is my responsibility to inform the teacher if I do not wish to receive physical assistance of this kind.
In consideration of being allowed to participate in yoga classes, I agree to assume full responsibility for my actions and for any injury, damages or losses I might suffer in the practice of yoga at Comeback Yoga.
I further consideration of being permitted to participate in the yoga classes, I knowingly, voluntarily, and expressly release the teacher, Comeback Yoga, and any of Comeback Yoga's employees, contractors, agents, officers, board members and other representatives from any and all liability, negligence, and all other claims arising from my participation in yoga classes. This waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns.
Which yoga class are you attending (day, time and location)?
*
Name
*
First Name
Last Name
Email (optional)
A copy of this form will be sent to your email address, if provided.
Phone Number (optional)
Please enter a valid phone number.
If you provided an email address, would you like to receive the Comeback Yoga email newsletter? (Sent about every other month.)
Yes
No
If you provided an email address, would you like to be notified about class cancellation. (Please note: Our YouTube classes are only canceled if there are technical issues at the time of recording. Therefore, we cannot give advanced notice.)
Yes
No
If you wish to be notified about class cancellations, please list which class or classes here (Please be specific and list the day and location of each class.):
Mailing Address (optional)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I have read the above Student Waiver of Liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.
Signature
*
Demographic Information
If comfortable, please fill out the below information about yourself. Collecting this data allows us to provide information to our funders and ensures that we may serve our entire community in the best way possible.
What gender do you identify as?
ie male, female, non-binary
Please specify your ethnicity?
ie Black, Latinx, Asian, caucasian, etc.
How are you affiliated with the military?
ie Veteran, active service, spouse, etc.
If you served in the military, were you in combat?
Yes
No
Submit
Should be Empty: