Slowflow & Soundbath at Graye’s Greenhouse

Date~

Sunday 11/17 from 11-noonWendesday 11/13 from 11-noon

Name

First NameLast Name

Email

example@example.com

Pronouns

She/HerHe/HimThey/Them

Date of Birth

Date

Experience w/ practicing yoga

I'm a beginner/it's still new to meI practice occasionally & have taken some classesI practice fairly often

Any questions/concerns:

I First Name Last Name hereby affirm that I am voluntarily starting a course of instruction in yoga/sound meditation on Date at Location/or Online . I am voluntarily participating in the activity entirely at my own risk.

In full consideration of the risk of injury while participating in the Activity, and for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives,knowingly and voluntarily participate in this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity,their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives,predecessors, successors and assigns, for any kind of risks related to traveling to and from as well as participating the Activity, which may include, but are not limited to, physical or psychological injury, pain,suffering, illness disfigurement, temporary or permanent disability, economic or emotional loss, and death.I acknowledge that I have carefully read this form and fully understand that it is a release of liability. I expressly agree to release and discharge the trainer or instructor (Tonya Poole or "Lady of the Leaf") from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action for personal injury or property damage.

I agree to the above waiver

Yes

If under 18, parent/guardian's full name & phone number:

This is a sliding scale $5-$15 ✨pay what you’re able✨ offering~please venmo upon registering to save your space: My venmo is Tonya-Poole-3 (linked in IG bio @terracotta.tonya) *if you do not have venmo please shoot me a message to setup other form of payment (paypal or credit/debit)🙏💛

Venmo payment todayMessaged @terracotta.tonya on ig today for paypal or to pay w/ a card on square

Slowflow Yoga & Soundbath at Graye's Greenhouse

Yoga & Soundbath Class Waiver