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Health Declaration and Release of Liability
I,
hereby agree to the following:
first name
last name
I am participating in classes or services during which I will receive information and instruction about yoga and health. I recognize that yoga requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any physical fitness program, including yoga. I represent and warrant that I have no medical condition that would prevent my participation in physical fitness activities.
In consideration of being permitted to participate in the yoga classes, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which I might incur as a result of participating in the program.
In further consideration of being permitted to participate in the yoga classes, I knowingly, voluntarily, and expressly waive any claim I may have against the instructor, the owner, or the leaseholder of the building for injuries or damages that I may sustain as a result of participating in classes or workshops held at Bloom Yoga and Counseling
That if I participate in other classes or events offered by Bloom Yoga and Counseling that I will also assume full responsibility for any injuries that may result from my participation, with the same considerations that this waiver stipulates for yoga (items 1-4 above). I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.
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