Waiver and Release of Liability Form
Please complete this waiver form in order to participate in any workshop or class with Joy Herbst at the WCWC.
Please complete this waiver form in order to participate in any workshop or class with Joy Herbst at the WCWC.
Please complete this waiver form in order to participate in any workshop or class with Joy Herbst at the WCWC.
I understand that dance and/or yoga and/or meditation includes physical movements and opportunity for relaxation, stress re-education and relief of muscular tension.
Participation in classes may include, but is not limited to, stretching, aerobic activity, meditation techniques, breathing techniques, and performing various yoga postures and dance movements, both quick and slow.
As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be eliminated. Yoga and dance may not be recommended and is unsafe under certain medical conditions. I affirm that I alone am responsible to decide whether to participate in. I will progress at my own pace, listening to my own body first.
If I am pregnant or become pregnant or am newly post-natal, my signature verifies that I am participating in dance or yoga classes with my medical care provider’s full approval.
I agree to not come to class under the influence of alcohol or recreational drugs. My signature is binding to this liability waiver from this day forth.
My completion of this form verifies that I am physically fit to participate in these classes and a licensed medical practitioner has verified my physical condition for participation in yoga and dance.
I acknowledge an inherent risk of exposure to various airborne illnesses exists in any public place where people are present.
By attending the classes at the WCWC, I voluntarily assume all risks related and agree not to hold Joy Herbst, Purnima Women’s Health LLC, the DBA WCWC, or their contractors, or volunteers liable for any illness or injury.
In registering for and participating in this class, I hereby state that I have read this form in completion, and agree with it in it's entirety. I hereby release Joy Herbst, Purnima Women’s Health LLC and the DBA Women’s Community Wellness Center from any and all liability, negligence or other claims arising from or in any way connected with my participation in any class or workshop at the WCWC.
NAME:
EMAIL ADDRESS:
MAILING ADDRESS:
DATE COMPLETED: