Yoga Liability Waiver

Please read carefully and complete all required information before participating in Massage Yogini, LLC Yoga classes.

First name

Last name

Email address

Phone number

Date of birth

By checking this box you acknowledge that Massage Yogini, LLC does not offer instruction to minors and that by participating in yoga services you confirm that you are 18 years of age or older.

Emergency Contact Information

Emergency contact name

Emergency contact phone

Relationship to emergency contact

Health Information

Do you have any injuries, medical conditions, or physical limitations?

Yes

No

If yes, please describe any injuries, medical conditions, medications, or physical limitations.

Are you currently pregnant?

Yes

No

Not applicable

I understand that Massage Yogini, LLC Yoga classes are not tailored for Prenatal Yoga. If I am pregnant, become pregnant, or am post-natal, I acknowledge that I am participating at my and my unborn child's risk. I have consulted with a physician who has cleared me to participate in this class. I release the instructor and Massage Yogini, LLC from any liability related to pregnancy.

Liability Waiver and Release

By signing below, I acknowledge that:

I understand that yoga involves physical movement and poses that may result in injury
I voluntarily participate in yoga classes at my own risk
I release the yoga instructor and studio from any liability for injuries that may occur
I will inform the instructor of any physical limitations or health concerns
I will not participate if I feel unwell or have any contagious conditions
I understand I should consult with a physician before beginning any exercise program

I have read and understand the above waiver and release. I agree to participate in yoga classes at my own risk and release the instructor and Massage Yogini, LLC from liability.

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Date signed