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Please fill out the following waiver prior to your first lesson. Thank you!
Emergency Contact Name & Phone
Level of Experience with Yoga?
Any Injuries (recent or longstanding)?
I agree that Holistic Flows, Jackie Herman is in no way responsible for the safekeeping of my personal belongings while I attend class. I understand that classes may be physically strenuous, and I voluntarily participate in them with full knowledge that there is risk of personal injury, property loss or death. Yoga is not a substitute for medical attention, examination, diagnosis, or treatment. Yoga is not recommended and is not safe under certain medical conditions. I affirm that I alone am responsible to decide whether to practice yoga. I agree that neither I, my heirs, assigns or legal representatives will sue or make any other claims of any kind whatsoever against Holistic Flows, Jackie Herman, its staff, private contractors or its members for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise.
If Participating in Kids or Pre or Post Natal Classes: I individually and as parent and/or guardian of the minor child identified above hereby acknowledge the following notices and grant to Holistic Flows, Jackie Herman the following release from liability: I acknowledge and fully understand that I, or my child, will be engaging in physical activities that may involve some risk of injury. I acknowledge and have been advised that it is my responsibility to consult with my or my child’s physician with respect to any past or present injury, illness, health problem or any other condition or medication that may affect my or my child’s participation. I assume the foregoing risks and accept full personal responsibility for any personal injuries sustained by my child or myself which might incur as a result or participating in this program and discharge and hold harmless Holistic Flows, Jackie Herman, it’s members, employees and agents from any claim, cause of action or liability for damages arising from any personal injury to myself, my child or other persons or property caused by myself or my child’s participation in yoga classes.
By clicking "submit" you are signing this waiver.
Terms & Conditions
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