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Student Intake & Waiver Agreement / Release Form 


Name *
Name
Date of Birth *
Date of Birth
Phone
Phone
Address *
Address
Please list and describe any injuries, medical conditions, and/or special accommodations that Sacred Space LLC and our teacher should know about
Student Waiver Agreement Form / Release
By checking the box below, typing my full name / date, and submitting this form: *
I understand and acknowledge that yoga includes physical movements as well as an opportunity for relaxation, stress reduction and relief of muscular tension. Participation in yoga class includes, but is not limited to, participation in meditation techniques, yogic breathing techniques, and performing various yoga postures. Yoga is an individual experience. I acknowledge that participation in yoga classes exposes me to a possible risk of personal injury. I am fully aware of this risk. I understand that it is my continuing responsibility to inform the instructor(s) and staff at Sacred Space LLC of all medical conditions, injuries, or surgeries, prior to my first class and at such other times as I acquire information as to same. I also understand that it is my responsibility to consult with a physician prior to and regarding participating in the yoga classes or workshops, and to receive prior approval to participate. I represent and warrant that I am physically fit and have no medical condition or injury which would prevent my full participation in the yoga classes or workshops. I shall not now or at any time in the future bring any legal action against instructor(s) and/or Sacred Space LLC for any injuries, conditions, and/or damages that I may sustain as a result of entering or being on the premises or participation in any provided classes and/or workshops; and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns. The Student Wavier Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I acknowledge that this Student Waiver Agreement form will be used by the persons or entities being released in the yoga classes and that it will govern my actions and responsibilities in said classes.
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Today's Date *
Today's Date