PALMS TOGETHER YOGA COLLECTIVE WAIVER

Please fill out the following medical form & sign the waiver

First Name

Email Address

Last Name

Date of Birth

I understand that yoga includes physical movements as well as an opportunity for relaxation, stress reduction, and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling is always present and cannot be entirely eliminated. I acknowledge that yoga is an exploration of a person’s physical and mental potential, and that my participation in a yoga class can cause potential serious injury, death, or property damage. If I experience any pain or discomfort, I will listen to my body, adjust the posture and ask for support from the teacher. I will continue to breathe smoothly.

Yoga is not a substitute for medical attention, examination, diagnosis, or treatment. Yoga is not recommended and is not safe under certain medical conditions. I agree to disclose any pertinent mental health concerns, medical conditions /concerns, or medications here:

Initials

Today's Date

By initialing, I declare that the info I’ve provided is accurate & complete and with a full understanding of the potential risks I hereby assume the risks of participating in a yoga class. I affirm that I alone am responsible to decide whether to practice yoga. I hereby agree to irrevocably waive, release, and discharge any claims and/or liabilities for personal injury, death or damages of any kind, that I now, or hereafter may have against any Directors or Members of the Palms Together Yoga Collective. I agree not to sue any of the persons or entities listed above for any of the claims or liabilities that I have waived, released or discharged herein. I indemnify and hold harmless the persons or entities mentioned above from any claims made or liabilities assessed against them as a result of my actions.

Thanks for submitting!