Qoya Waiver Form: Erin Nes Therapy
I, the undersigned, understand that Qoya is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including Qoya. I recognize that it is my responsibility to notify my teacher of any serious illness or injury before every class. I will not perform any movements to the extent of strain or pain. I accept that neither the instructor, nor the hosting facility is liable for any injury or damages to person or property resulting from taking of the class. Those under 18 years of age must have this form signed by a parent or guardian. If you have any questions, please contact us at info@erinnestherapy.com
Full Name of Participant
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First Name
Last Name
Guardian's Name (if participant is under 18)
First Name
Last Name
Email
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example@example.com
Date
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Month
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Day
Year
Date
E-Signature
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Type your full name.
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