Waiver Form | Hands to Heart Yoga

Hands to Heart Yoga Practice Liability Waiver

First Name

Last Name

Date of Birth

Do you have a doctor’s permit to participate in intense physical activities?

Yes

Please specify anything we should know about

Initials

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I agree to disclose my physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in this program.

I am participating in yoga classes, health programs, workshops and/or other wellness, body work, therapy, exercise and healing arts activities (collectively, the “Activities”) offered by Hands to Heart Yoga and Wellness (the “School”). The Activities may be offered at the School or online by videos and other digital media or platforms. All offerings, either physical or online, shall be considered “Activities.” . I am aware that I must be in adequate physical and mental health to participate in the Activities and that they may require physical exertion that may cause or aggravate a condition. I agree that I am fit enough to participate. I agree that I am solely responsible for my own health safety and well-being while participating. I am aware that my participation could result in high blood pressure, fainting, heart issues, physical injury, heart attack or stroke and may aggravate pre-existing injuries. I am aware that I could experience muscle, back, neck and other injuries due to participation in the Activities. I am sufficiently self-aware to stop or modify my participation before I become injured. I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the Activities at the School, including those which may result from the negligence of the School. I knowingly, voluntarily and expressly waive any “Claim” (as defined below) I may have against the School, its owners, managers, teachers, instructors, workshop presenters, employees, independent contractors and staff (each, a “Released Party”) that I may sustain as a result of participating in the Activities at the School even if the Claim arises from the negligence of any Released Party or anyone else. I agree to indemnify and hold harmless each Released Party from any loss, cost, or liability incurred in defending any Claim made by me or anyone making a Claim on my behalf, even if the Claim is alleged to or did result from the negligence of any Released Party or anyone else. “Claim” includes but is not limited to any and all liabilities, claims, demands, expenses, fees, legal actions, rights of actions for damages, personal injury, mental suffering and distress, or death that I may suffer, my spouse, children or unborn child may suffer (including any legal fees or expenses) in connection with participation in any Activity. I hereby understand that the School from time to time may photograph, video, or otherwise record classes or events occurring at the School and place such photographs and videos on its Website or social media platform. I hereby consent to the use of my image that may appear in any such photograph or video. In consideration of the risk of injury, allergic reaction, asthma or other respiratory distress or skin irritation that exists from purchasing and using homemade soaps, scrubs and herb bundles, as well as and including essential oils, and in consideration of my desire to purchase and use these products, I hereby knowingly release and discharge the School and any of their affiliates, from any physical or psychological injury that I may suffer as a direct result of my purchase and use of the products mentioned. I have carefully read this agreement and fully understand its contents. I voluntarily and knowingly agree to the terms and conditions stated herein. I’m aware that by signing this agreement, I’m giving up substantial rights, including my right to sue.

Thanks for submitting!