Waiver of Liability Form

 

 

Tap here to fill out Waiver of Liability Form

 

 

RELEASE AND WAIVER OF LIABILITY

Sasha Stine
The Light Poured In Yoga
Fishers, Indiana
thelightpouredin@gmail.com

 

 

Please read thoroughly, and sign to indicate your agreement:

 

• I acknowledge that I am participating in yoga classes, health programs, workshops and/or other wellness, body work, exercise and healing arts activities (collectively, the “Activities”) offered by Sasha Stine (Certified Instructor). The Activities may be offered in a physical location or offered online via digital media or platforms. All of such offerings, either physical or online, shall be considered “Activities.”

 

• I understand that the Activities may require intense physical exertion, and I represent and warrant that I am physically fit enough to participate, and I have no medical condition which would prevent my full participation in the Activities.

 

• I understand that it is my responsibility to consult with a physician before my participation in the Activities.
I understand my physical limitations and I am sufficiently self-aware to stop or modify my participation in any Activity before I become injured or aggravate a pre-existing injury.

 

• By signing this consent form, I understand that I am personally responsible for my actions while participating in these Activities, and that I waive all responsibility of the Teacher if I should incur any injury as a result of my negligence.