Prenatal Class Registration

I understand that physical exercise can be strenuous and there is inherent risk in participating in any exercise program. I agree to assume those risks personally and hereby release Knoxville Hospital Doula, LLC, 4th Trimester Fitness® LLC, the owners of the business and building at which classes are held, their members, managers, employees, agents, representatives and instructors (the “Released Parties”) from any and all claims or liability, loss or expense for any injury or discomfort I or my baby may sustain as a result of my participation in this program. I understand that I am not required to participate in any or all of the body movements demonstrated by Knoxville Hospital Doula, LLC and/or the 4th Trimester Fitness® LLC instructor, and that nothing we do in class should ever be painful. I represent that I have consulted with my physician before participating in this activity. I understand that this is a group fitness or childbirth education class, that the Released Parties are not providing physical therapy or medical services, advice or treatment, and that the Released Parties are not acting as my physician, physical therapist, or one-on-one personal trainer. I give permission for photographs taken of me and my baby while participating in the class to be used in social media and marketing/public relations materials in the promotion of Knoxville Hospital Doula, LLC, 4th Trimester Fitness® LLC and its classes. At any time during class, I can let the instructor know that I prefer not to be photographed.

By choosing to participate in individual, small group, on or off-site yoga, meditation, and wellness programs, you voluntarily assume your own risk. It is always wise to consult with your physician before embarking on any health or wellness program. If you have an existing health condition, it is your personal responsibility to refrain from or modify any physical movements or positions that may compromise your condition. You will receive knowledgeable yoga instruction by a registered yoga teacher. However, personal awareness is fundamental to the practice of yoga. As a student, it is solely your responsibility to monitor each activity offered and determine whether it is appropriate for you to participate, and to what level. ALI COHEN, CD(DONA), RYT200/RPYT, ON BEHALF OF KNOXVILLE HOSPITAL DOULA, LLC as well as the owner(s) of the facility at KNOX COUNTY TENNESSEE PARKS & RECREATION and/or ROOTS & WINGS MIDWIFERY, are not liable for ensuring your safety and wellbeing.While people generally experience greater health and wellness as a result of embracing a healthier attitude and incorporating balanced yoga and mindful meditation into their lives, ALI COHEN, CD(DONA), RYT200/RPYT, ON BEHALF OF KNOXVILLE HOSPITAL DOULA, LLC does not promise or guarantee, and is in no way responsible, for specific outcomes. You will receive physical support, including but not limited to, hands-on adjustments and assistance from yoga instructors. Such physical contact is intended to enhance your practice and ensure proper alignment and technique. By signing this form you consent to receive such physical adjustments and understand that participating in yoga, including receiving physical assistance, carries inherent risks, including the possibility of injury. If you do not wish to receive such physical assistance it is solely your responsibility to inform the instructor at any time if you do not wish to receive physical assistance, and that such refusal will not affect your participation in the class. ALI COHEN, CD(DONA), RYT200/RPYT, ON BEHALF OF KNOXVILLE HOSPITAL DOULA, LLC, as well as the owner(s) of KNOX COUNTY TENNESSEE PARKS & RECREATION and/or ROOTS & WINGS MIDWIFERY, are not liable for ensuring your safety, comfort, and wellbeing. By signing this form, you agree that ALI COHEN, CD(DONA), RYT200/RPYT, ON BEHALF OF KNOXVILLE HOSPITAL DOULA, LLC, as well as the owner(s) of the facility at KNOX COUNTY TENNESSEE PARKS & RECREATION and/or ROOTS & WINGS MIDWIFERY, are in no way responsible for the safekeeping of your personal belongings. You understand that physical movement in any form may pose a risk of personal injury or death. You voluntarily assume all risks associated with yoga practice, including any injury or discomfort that may arise from physical adjustments provided by yoga instructors. You understand that ALI COHEN, CD(DONA), RYT200/RPYT, ON BEHALF OF KNOXVILLE HOSPITAL DOULA, LLC and the owners of KNOX COUNTY TENNESSEE PARKS & RECREATION and/or ROOTS & WINGS MIDWIFERY will not be held liable for property damage or loss, personal injury, or death.I agree that neither I, nor my heirs, or legal representatives will sue or make any other claims of any kind whatsoever against ALI COHEN, CD(DONA), RYT200/RPYT, ON BEHALF OF KNOXVILLE HOSPITAL DOULA, LLC, its owners, instructors, employees, or agents, as well as the owner(s) of the facility at KNOX COUNTY TENNESSEE PARKS & RECREATION and/or ROOTS & WINGS MIDWIFERY, or its clients and members for any personal injury, discomfort, property damage/loss, or wrongful death, whether caused by negligence or otherwise.