Registration & Liability Waiver for Yoga with Carrie J Meyer, www.carriejmeyer.com
Name ____________________________________________________________
Address (street) ____________________________________________________
City/State/Zip______________________________________________________
Cell Phone ______________________ Email _____________________________
Emergency Contact ________________________ Cell Phone ________________
DOB________________Occupation ____________________________________
I understand and agree that the undertaking of yoga and any physical activity comes with various risks to my body and health, including the risk of injury and/or death, and I voluntarily assume full responsibility for such risks, known and unknown, when I participate in a yoga class or receive yoga instruction from Carrie J Meyer or her substitute teachers. I assume all risks whether working with my own yoga mat and props or those provided by Carrie J Meyer, her substitutes, or the establishment at which Carrie or her substitute are offering yoga instruction.
I understand and agree that it is my responsibility to consult my physician regarding the appropriateness of my participating in yoga before I do so and at any time there is a question about the safety of my participating in yoga.
I attest that to the best of my knowledge I am physically and mentally fit to participate in yoga with Carrie J Meyer or her substitute teachers and I will take appropriate care of myself in every class, whether practicing in person or virtually through an online platform, especially if/when I have an injury, illness or condition that may affect my ability to safely practice yoga.
I understand and agree that I will inform Carrie J Meyer or her substitute teachers of any conditions affecting my ability to safely practice yoga and agree that, even when I share this information, I still assume full responsibility for my personal safety in practicing yoga under the instruction or guidance of Carrie or her substitute teachers.
I understand and agree that I am responsible for the safekeeping of all of my personal possessions or belongings at all times and recognize that neither Carrie J Meyer, nor her substitute teachers, nor the establishment at which Carrie or her substitute are offering a yoga class or workshop are responsible for my belongings.
I understand and agree that if I am under 18 years of age, I must have my parent or guardian provide legal consent for my participation in yoga with Carrie J Meyer or her substitute teachers.
I hereby release, indemnify, and hold harmless Carrie J Meyer, her substitute teachers, and any establishment at which Carrie or her substitutes offer yoga instruction with respect to any and all injury, disability, death, loss or damage to person or property that may arise through association or experience with the above named.
I attest that I fully understand the contents and implications of this liability waiver and am voluntarily signing in acknowledgement of my agreement. I understand that this liability waiver shall remain in effect indefinitely.
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Signature Date
Please list any physical conditions, illnesses, or injuries, and indicate if they are currently affecting you
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