• Mary Golden Wellness Consent Form

    Please Fill out - takes 3 minutes!
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • By checking the following boxes, confirm that you willingly consent to the following terms and conditions:
  • Participation with Mary Golden Wellness includes but is not limited to: yoga, nervous system regulation, physical movement, stretching and strengthening postures, breathing, balance, mindfulness, meditation, self-touch/massage, relaxation, writing, sharing, reflecting and supporting one another. These techniques invite us to safely connect with ourselves through self-care while incorporating physical, mental, emotional and spiritual well-being.

  • I understand that I am empowered as the decision-maker for my own well-being but it is also wise to check in with my healthcare provider before starting any new healthcare, fitness or wellness regimen. If at any point, I feel overexertion, pain or fatigue, it is my responsibility to respect my own limitations and rest before continuing. I will also inform my guide using my voice, raising a hand or via the live chat during virtual sessions.

    In any physical activity, risk of serious physical injury is possible. I realize that I am participating in activities at my own risk. Activities performed within Mary Golden Wellness are not a substitute for medical diagnosis and treatment. To the best of my knowledge, I have NO medical condition, which would prevent me from taking part in these activites.

    I verify that the information I have provided on this form is truthful and accurate. I assume responsibility for any risk or injury I may sustain as a result of my participation. I have read the entirety of this document and understand its contents. I agree to the terms and conditions stated above. My signature is binding to this liability and this form from this day forth. 

  • Date
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  • Which Free Live Event(s) would you like to join for The Mary Golden Wellness 1 Year Anniversary Celebration?
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