• Yoga for Social Healing Participant Release

    Complete this release, waiver of liability, and media consent form to participate in the Yoga for Social Healing event. All fields are required.
  • Release & Waiver of Liability

    Please carefully review the following before signing.

    I acknowledge that I am voluntarily participating in the Yoga for Social Healing event presented by Soul Fire Yoga and Healing Lab Somatic Therapy.

    I understand that this event may include yoga, stretching, physical movement, breathwork, meditation, mindfulness, somatic practices, wellness activities, healing arts activities, educational discussions, and other related activities (collectively, the “Activities”).

    I recognize that I must be in adequate physical and mental health to participate in the Activities. I understand that the Activities may involve physical exertion and may cause or aggravate physical injuries, medical conditions, or physical or emotional discomfort.

    I understand that it is my responsibility to determine whether I can safely participate and to consult an appropriate healthcare professional before participating if I have concerns regarding my physical or mental health.

    I understand my own limitations and agree to stop, modify, or decline participation in any Activity if I experience pain, dizziness, discomfort, distress, or otherwise believe continuing would be unsafe or inappropriate for me.

    Assumption of Risk

    I understand that participation in the Activities involves inherent risks, including but not limited to muscle strains, sprains, falls, dizziness, fainting, elevated blood pressure or heart rate, back or neck injuries, aggravation of pre-existing injuries or medical conditions, physical discomfort, and other physical or emotional responses associated with participation.

    I knowingly and voluntarily assume full responsibility for any risks, injuries, losses, or damages, whether known or unknown, that I may incur as a result of participating in the Activities.

    Release & Waiver

    In consideration of being permitted to participate in the Yoga for Social Healing event, I knowingly, voluntarily, and expressly release and waive Claims arising from my participation in the Activities against Soul Fire Yoga, Healing Lab Somatic Therapy, and their respective owners, instructors, therapists, practitioners, employees, independent contractors, volunteers, representatives, agents, event facilitators, and staff (collectively, the “Released Parties”).

    To the fullest extent permitted by applicable law, this release includes Claims arising from the ordinary negligence of a Released Party.

    “Claim” includes, but is not limited to, liabilities, claims, demands, expenses, legal actions, damages, personal injury, emotional or mental suffering or distress, property damage, or death arising from or relating to my participation in the Activities.

    To the fullest extent permitted by applicable law, I, my heirs, next of kin, executors, administrators, assigns, and legal representatives release and discharge the Released Parties from Claims covered by this agreement and agree not to sue a Released Party for an injury, loss, or damage that I have released through this agreement.

    To the fullest extent permitted by applicable law, I agree to indemnify and hold harmless the Released Parties from losses, costs, or liabilities incurred in defending a Claim brought by me or on my behalf that I have released through this agreement.

    Photography & Videography Consent

    I understand that photography, videography, and other media recording will take place during the Yoga for Social Healing event.

    As a condition of participation in the event, I consent to being photographed, filmed, and/or otherwise recorded.

    I authorize Soul Fire Yoga and Healing Lab Somatic Therapy to photograph, film, record, reproduce, publish, and use my image, likeness, and appearance for promotional and business purposes, including websites, social media, digital marketing, advertising, promotional materials, and promotion of future events.

    I understand that these photographs and recordings may be publicly displayed, published, or distributed and may remain publicly available after the event. I understand that I will not receive compensation for the use of these photographs or recordings.

    I waive the right to inspect or approve photographs, videos, recordings, or finished promotional materials in which my image or likeness appears.

    Emergency Medical Care

    If I become ill or injured during the event and am unable to make decisions for myself, I authorize representatives of Soul Fire Yoga and/or Healing Lab Somatic Therapy to contact emergency medical services when reasonably necessary.

    I understand that I am responsible for costs associated with medical treatment or emergency transportation provided to me.

    Governing Law & Severability

    This agreement shall be construed in accordance with and governed by the laws of the State of Indiana.

    If any provision of this agreement is determined to be invalid, illegal, or unenforceable, that determination shall not affect the validity or enforceability of the remaining provisions.

    Acknowledgment

    I acknowledge that I have carefully read and fully understand this Participant Release, Waiver of Liability & Media Consent. I understand that participation involves risks and that by signing this agreement I am voluntarily assuming certain risks and giving up substantial legal rights, including certain rights to bring a claim or lawsuit against Soul Fire Yoga, Healing Lab Somatic Therapy, and the other Released Parties.

    I also consent to the photography and videography provisions described above. I voluntarily and knowingly agree to all terms of this agreement.

  • Format: (000) 000-0000.
  • Date of Birth*
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    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Date Signed
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    2 digit month, 2 digit day, 4 digit year
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