Client Participation Waiver
Complete your details, review the participation, health, and online session terms, and provide your signature and consent choices.
Section 1 - Client Information
Full Legal Name
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First Name
Middle Name
Last Name
Date of Birth
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Month
-
Day
Year
Date
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Section 2 - Assumption of Risk & Liability Release
I understand that participation in fitness and movement classes — including but not limited to yoga, Pilates, aerial arts, mat-based, barre-style, and apparatus-based training — whether conducted in-person or virtually (online), involves physical activity that carries inherent risks. These risks include but are not limited to: muscle soreness, strains, sprains, or other physical injury; aggravation of pre-existing injuries or medical conditions; falls or accidents during aerial, apparatus, or floor-based activities; and injury resulting from equipment use or environmental factors. I voluntarily assume all such risks. I hereby release, waive, and discharge Tribal Yoga, LLC, its instructors, staff, affiliates, and representatives from any and all claims, demands, damages, losses, or liabilities arising out of or related to my participation in any session or program, whether caused by negligence or otherwise. I agree that this release is binding on my heirs, assigns, and legal representatives.
I have read and agree to the Assumption of Risk & Liability Release above
*
I agree
Section 3 - Health History & Medical Disclaimer
I confirm that I am in adequate physical condition to participate in a fitness or movement program. I have disclosed, or agree to disclose prior to my first session, any known medical conditions, injuries, surgeries, or physical limitations that may affect my participation, including but not limited to: cardiovascular conditions or high blood pressure; pregnancy or recent postpartum recovery; joint, bone, or musculoskeletal conditions; neurological conditions, dizziness, or fainting history; or any recent illness, surgery, or injury. I understand that instructors are not licensed medical professionals and that nothing in sessions constitutes medical advice, diagnosis, or treatment. I agree to consult a qualified physician before beginning any new exercise program if I have any health concerns.
I have read and agree to the Health History & Medical Disclaimer above
*
I agree
Health Disclosure
Section 4 - Online / Virtual Session Acknowledgment
If I participate in virtual or online sessions, I acknowledge that the instructor has limited ability to physically assist, spot, or correct my form remotely; I am solely responsible for ensuring my workout space is safe, clear, and appropriate; I will use only equipment that is in safe, working condition; and I take full personal responsibility for my safety during all online sessions.
I have read and agree to the Online / Virtual Session Acknowledgment above
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I agree
Section 5 - Photo & Video Consent
Do you consent to Tribal Yoga, LLC using photos or videos in which you appear (taken during sessions or events) for promotional purposes, including social media, the business website, and marketing materials? Your personal contact information will not be shared.
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Yes, I consent
No, I do not consent
Section 6 - Minor Participant (Under 18)
Complete this section only if the participant is under 18. Leave blank if 18 or older.
Minor's Full Name
First Name
Middle Name
Last Name
Minor's Date of Birth
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Month
-
Day
Year
Date
Parent/Guardian Full Name
First Name
Middle Name
Last Name
Relationship to Minor
Section 7 - Acknowledgment & Signature
By signing below, I confirm that I have read and fully understand this waiver; I am signing voluntarily; I am 18 years of age or older OR I am a parent/guardian signing on behalf of a minor; and all information provided is accurate and complete.
Client / Guardian Signature
*
Date
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Month
-
Day
Year
Date
Print Full Name
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First Name
Middle Name
Last Name
Submit Waiver
Submit Waiver
Should be Empty: