Name *
Name
Address *
Address
Phone *
Phone
Do you have any injuries or health concerns that you would like us to know about that may affect your practice?
Date *
Date
Birthdate
Please read waiver carefully.
Waiver *
By registering above as a student of Yoga Hana, I agree to the following: 1. I am aware of the physical risks involved with strenuous exercise and understand that it is my personal responsibility to consult with my physician prior to my participation in any classes or prior to receiving any instruction. I also understand that if at any time during any class or when receiving any instruction from you and/or your associated instructors that I feel discomfort or strain, it is my responsibility to cease the activity and consult with my physician. I agree that I am solely responsible for the decision to practice yoga and that I have no known medical condition which would prevent me from taking part in yoga classes or receiving yoga instruction. I assume responsibility for any risk or injury that I may sustain as a result of my participation. I also agree and understand that yoga is not a substitute for medical treatment or attention and that I should consult with my physician prior to beginning any new activity program including yoga. 2. I will not hold Yoga Hana, its owners, associated instructors, and employees, responsible for any injuries suffered by me caused in whole or in part by my failure to follow the instructions given, or by any physical impairment of mine. I understand that it is my responsibility to advise you, your staff, and your associated instructors of any physical conditions that may limit my participation in yoga classes and to work only within my limitations. 3. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Yoga Hana, its agents, owners, officers, directors, instructors, sponsors, and other participants as well as any Yoga Hana class or instruction. 4. I agree that Yoga Hana is not responsible in the event of loss, damage, unauthorized use, theft, or injury resulting from and to any personal property that I bring onto the premises. 5. I understand that Yoga Hana reserves the right to refuse admittance to anyone Yoga Hana or the agents thereof think may pose a health risk to themselves or to others. 6. Participation in yoga class includes, but is not limited to, participation in meditation techniques, yogic breathing techniques, and performing various yoga postures. Yoga postures, or asanas, are designed to exercise every part of the body stretching and toning the muscles and joints, the spine and the entire skeletal system. They also work on the internal organs, glands and nerves. Yoga incorporates sustained stretching to strengthen muscles and increase flexibility. Yoga is an individual experience. 7. My signature further acknowledges that I shall not now or at any time in the future bring any legal action against Yoga Hana, its agents, owners, officers, directors, instructors, sponsors, and other participants, and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns. My signature verifies that I am physically fit to participate in yoga classes and a licensed medical doctor has verified my physical condition for participation in this type of class.

If I am pregnant or become pregnant or am post-natal, my signature verifies that I am participating in yoga classes with my doctor’s full approval. I realize that I am participating in yoga classes at my own risk. I will inform the teacher if I am pregnant or post-natal. 

 8. Students must adhere to the studio ettiequte guidelines listed below: Arrive for class on time, allowing enough time to sign in and set up your practice space. Do not leave during savasana (final relaxation). This is extremely disruptive to everyone else who is being still and silent. In a Mysore class you may leave early, but please be out the door before savasana begins. In a guided class, if you must leave early, please inform the teacher before class, then make sure you allow enough time to put your belongings away, and to be out the door before the start of the group savasana. Please do not wear any perfume, cologne, after shave, essential oils, or scented antiperspirant, shampoos, or conditioners. Just like natural body odors, these artificial odors will be intensified by the heat of the practice. Some students who come to the studio are very sensitive to chemicals. Please help them. This includes all “natural” or “organic” scents as well. Make sure that your body, your clothes and your mat are clean and odor free. It is traditional to bathe before and after class. Roll out your mat in line with the others in the room, and square to the room shape. This not only looks neater, it will help you and those around you stay balanced as you practice. If someone else is looking for space for their mat, and you have some, offer it. People are shy about asking. and if you must walk about during class, please do not step on other people’s mats. Put all props you’ve taken back neatly in their proper place after class. (Courtesy of The Yoga Workshop) My signature is binding to this liability waiver from this day forth.