Yoga Waiver Form

Peace of Mind Yoga with Christa

Name

First NameLast Name

Email

example@example.com

Phone Number

Address

Street Address

Street Address Line 2

City Province

Postal Code

Emergency Contact

Phone Number

Are you currently experiencing any of the following?

Disclaimer (Please Read Carefully)

I, the undersigned, understand that this practice is not a substitute for medical attention, examination, diagnosis or treatment. I should consult a medical professional before beginning any program, including yoga, for my overall well-being. I recognize that I must notify my instructor of any illness or injury before the class. I will not perform any postures beyond my capabilities. I accept that neither the instructor nor the venue is liable for any injury, or damages, to persons or property resulting from participating in these sessions.

Signature

Date

I agree to all of the above and that I have been open and honest about my health

I agree