The Planted Yogi Registration and Waiver Form Logo
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  • Registration & Intake Form

  •  I, the below signed, hereby agree to the following:
     That I am participating in the Yoga Classes, Meditation, Health Programs, Workshops or other activities and/or programs (“Programs”) offered by Ciara Martin, dba The Planted Yogi, during which I will receive information and instruction about yoga and health. The practices may include, but are not limited to physical movements, breathwork, and meditation.
     
    I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education, and relief of muscular tension. I recognize that yoga requires physical exertion that may be strenuous and may lead to physical injury. As is the case with any physical activity, the risk of injury is always present and cannot be entirely eliminated.
     
    I understand that it is my responsibility to listen to my body and not exceed my own physical and mental abilities. I understand that, while The Planted Yogi puts forth effort to ensure that online and in person programs are safe for everyone, I also understand and fully recognize that certain risks may exist when I participate in a physical activity such as yoga. These risks may lead to serious bodily injury, disability, or emotional injury.

     

    These risks include (but are not limited to):

     

    Pre-existing conditions, in-person sessions, or at my own studio, use of improper exercise aids, inability of the instructor to fully view students’ performance of activities while online, interference with the online experience by uninvited third parties (such as hackers), tripping hazards and other obstacles created by other students, and other similar occurrences, lack of confidentiality and private spaces; close contact with contagious persons including those with Covid-19;  wild and domestic animals; exposure to biting and stinging insects; drowning; dizziness; poisonous plants; inclement weather, precipitation, wind and lightning; uneven terrain;  wild fire or flood; high altitude illness; dehydration; cold and/or hot climate and weather; exposure to sunlight; traffic and pedestrians; and other similar dangers

     

    With full understanding of the risks involved, I am voluntarily choosing to participate in The Planted Yogi programs, and the filming of such programs.

     


    I will make the instructor aware of any medical conditions or physical limitations that I may have by email well in time before class. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Yoga Classes, Meditation Classes, Health Programs or Workshops. I represent and warrant that I am physically fit and have no physical, medical, mental or emotional condition that would prevent my full participation in the Yoga classes, Meditation Classes, Health Programs or Workshops. I acknowledge that The Planted Yogi, its contractors and employees, do not provide medical advice, diagnosis, or treatment.
     
    In further consideration of being permitted to participate in Yoga Classes, Meditation Classes, Health Programs, or Workshops, I knowingly, voluntarily and expressly hereby irrevocably and unconditionally release, waive, relinquish, discharge from liability and covenant not to sue Ciara Martin, The Planted Yogi, other persons using Ciara Martin's facility, and their successors, predecessors-in-interest, and insurers (collectively, the “Releasees") from any and all claims, demands, rights, actions, suits, causes of action, obligations, debts, costs, losses, charges, expenses, attorneys’ fees, damages, judgments and liabilities, of whatever kind or nature, in law, equity or otherwise, whether now known or unknown, suspected or unsuspected, and whether or not concealed or hidden, related to or arising, directly or indirectly, from my use of Ciara Martin’s facility or services, my participation in outdoor activities,, and/or the acts or omissions of Ciara Martin or any of the Releasees, including without limitation any claim for negligence, failure to warn or other omission, property damage, personal injury, emotional injury, illness, bodily harm or death. In the event that any claim released herein is brought by, or asserted on behalf of me, I shall indemnify, defend and hold harmless the Releasees, and any of them, from any loss or liability, including reasonable attorneys' fees, associated therewith or arising therefrom. This waiver shall not apply to damages and claims arising due to the gross negligence or intentional act of The Planted Yogi or its independent contractors or employees.    In the event that The Planted Yogi successfully defends this Agreement and/or clause in court, mediation, or other legal action, I shall be liable for all The Planted Yogi’s costs, including reasonable attorneys’ fees and expert witness fees.


    By signing electronically, I agree that I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.                                                                                                  

    I accept that Ciara Martin is not liable for any Injury, or damages, to person or property, resulting from participating in these sessions.

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  • Publicity release: I understand that The Planted Yogi may photograph, record, or videograph me or my home/studio environment as part of the in person or online trainings. If initialed, I grant The Planted Yogi the nonrevocable license to use my likeness, voice, mannerisms, and silhouette throughout the world in any media for business purposes of The Planted Yogi and its assigns, including reuse for online instructional videos, training, educational programing, marketing and advertising, and social media posts.

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