YOGA LIVING CENTER
Living Yoga... One breath at a time
Student Waiver Form
The
(Please Print Clearly)
Name:
_____________________________________
Date: _____________________
Preferred
Phone #: ____________________ Alt
Phone #: ____________________
E-mail
address: _________________________________________________________
Address:
_______________________________________________________________
City:
_____________________ State:
_________________ Zip Code: _________
I understand that yoga
includes physical movement as well as an opportunity for relaxation, stress
re-education and relief of muscular tension. As in the case with any physical
activity, the risk of injury, even serious or disabling, is always present and
cannot be entirely eliminated. If I
experience any pain or discomfort, I will listen to my body, adjust the posture
and ask for support from the teacher.
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. The Yoga Living Center, its personnel and
staff conducting a workshop or yoga
class, are totally free from responsibility, personally and legally for any
injury incurred by you, the participant.
Signature:
______________________________________
Date: ________________
