Fill out the Digital Yoga Liability Waiver Form in just a few minutes by using the WaiverElectronic system.

Template background

 

Waiver of Liability & Disclosure Form ​
 
Please read, initial and sign.

I understand there is an inherent risk associated with any exercises including my voluntary participation in Yoga, Thai Yoga, Pilates and the use of equipment and props that may result in injury. The exercises related to Yoga, Thai Yoga, Pilates and the use of equipment and props will challenge my strength, agility, flexibility and cardio respiratory system. I understand and am aware that the components of exercises related to Yoga, Thai Yoga and Pilates and use of any equipment and props are potentially hazardous and may cause injury.

I acknowledge that I have either had a physical examination and/or have been given permission from my physician to participate in Yoga, Thai Yoga and Pilates based exercises with or without the use of equipment and props or I have decided to participate in Yoga,Thai Yoga and Pilates based exercises with or without the use of equipment and props voluntarily without the approval of my physician and do herby assume all responsibility for my participation in any Yoga, Thai Yoga and Pilates based exercises, activities, workshops and use of any equipment and props associated with and offered by Kayla L. Rossley Rodenhiser.

I certify that I am physically well and not suffering from medical problem, conditions, impairments, diseases, or any other illness that would prevent my full participation or increase my risk of injury and/or illness as a result of partaking in any Yoga, Thai Yoga and/or Pilates based exercises, activities, workshops and use of any equipment and props.

I understand that a variety of equipment and props, which could include but is not limited to: Yoga straps, bolsters, blocks, mats, chairs, resistance bands, magic circles, spinal correctors, foam rollers, and Pilates balls may be used.

I acknowledge there are risks posed by participating in online classes and private sessions, as there is no in-person supervisions or space provided for me. I agree that I am responsible for the safe facilitation of the activities that take place online both live or recorded. I agree to ensure my safety, using my judgment not to push myself too far or attempt anything I feel unsure how to perform. 

I acknowledge that tripping or collision with human or natural elements, sun exposure, dehydration, insects, exposure to infections, diseases, pollutants and other environmental factors can occur. I understand and agree it is my responsibility to ensure a safe space and environment to particpate in any Yoga,Thai Yoga and/or Pilates based exercises, activities, workshops and use of any equipment and props.

I agree that it is solely my responsibility to safeguard my personal items, and Kayla L. Rossley Rodenhiser is in no way responsible for any of my personal property that is damaged, lost, or stolen before, during, or after my participation in any Yoga,Thai Yoga and/or Pilates based exercises, activities, workshops and use of any equipment and props offered by Kayla L. Rossley Rodenhiser.

I, my heirs, next of kin or legal representatives, do herby forever waive and release Kayla L. Rossley Rodenhiser from any and all liability and responsibility from injury, accident, illness, death, legal and medical fees sustained now or in the future resulting from my participation in any Yoga,Thai Yoga and/or Pilates based exercises, activities, workshops and use of any equipment and props.

Initials Here
Please click the yellow area and provide your initials here.

I acknowledge that I have read this waiver of liability form. I fully understand its terms and conditions and understand that I am waving and giving up my right to sue Kayla L. Rossley Rodenhiser. I acknowledge that I am signing this agreement voluntarily and intend by my signature for this to be a complete and unconditional release of liability to the greatest extent allowable by law.

 

Please enter your full name.
Click to sign
Please sign here.
Please enter valid date.
Please enter valid date.
Please enter your phone number.
Please enter your email.