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200 Hour Yoga Teacher Training Registration and Release

I acknowledge that it is my duty to exercise ordinary care for the protection of others and myself while participating in the200 HourYoga Teacher Training (Teacher Training) at Hot Asana Yoga Studio LLC (Hot Asana). I assume the risk of all activity, whetherphysical or non-physical. I have received advice from my doctor that I am capable of physical exercise such as provided by Hot Asana, or I will seek such advice prior to participating, or I will assume the risk of exercising without a doctors examination.

I take complete responsibility formy participation in the Teacher Training provided by Hot Asana andI will not hold Hot Asana, its owners or instructors responsible for any injuries or loss I may incur as a result of my participation in the Teacher Training. I understand my physical limitations and am sufficiently self-aware to stop physical activity before I become ill or injured. I am in proper physical condition to participate inextensive, physically demanding training, and am aware that participation could, in some circumstances, result in physical injury, serious physical injury or death and I am knowingly assuming that risk.

I hereby confirm that I am at least 18 years of age, andI have read and fully understand this 200 Hour Yoga Teacher Training Registrationand Release(Release)and fully understand its terms, and sign it freely and voluntarily without inducement. In consideration for my participation in the Teacher Training, I, individually and on behalf of my relatives, legal representatives, and assigns, agree not to sue and agree to defend, indemnify, release and hold harmless, Hot Asana, its owners, members, and agents, from all actions, claims, demands, suits, losses, liabilities, charges, expenses (including attorneys' fees), and costs which may arise out of, relate to, or result from, any injury, economic loss or damage to me resulting from my participation in physical exercise, instructional classes, teacher training and other related activities.This form continues to be effective as long as I attend Teacher Trainingat Hot Asana.

I agree that this Releaseis intended to be a complete release of responsibility for personal injuries and/or property loss/damage sustained by my while participating in the Teacher Training. I understand that this Releaseis intended to be as broad and inclusive as is permitted by the laws of Kansas and that if any portion of this Releaseis held invlaid, I agree that the balance of this Releaseshould continue in full force and effect.

I agree that my full tuition is non-refundable after completion of the first weekend session of the training.

I Agree

First Yogi's Name

First Name*

Last Name*

Phone*
First Yogi's Age Acknowledgment*
First Yogi's Date of Birth*
I certify that I am 18 years of age or older
First Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
First Yogi's Signature*
Second Yogi's Name

First Name*

Last Name*
Second Yogi's Date of Birth*
Second Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Third Yogi's Name

First Name*

Last Name*
Third Yogi's Date of Birth*
Third Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Fourth Yogi's Name

First Name*

Last Name*
Fourth Yogi's Date of Birth*
Fourth Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Fifth Yogi's Name

First Name*

Last Name*
Fifth Yogi's Date of Birth*
Fifth Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Sixth Yogi's Name

First Name*

Last Name*
Sixth Yogi's Date of Birth*
Sixth Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Seventh Yogi's Name

First Name*

Last Name*
Seventh Yogi's Date of Birth*
Seventh Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Eighth Yogi's Name

First Name*

Last Name*
Eighth Yogi's Date of Birth*
Eighth Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Ninth Yogi's Name

First Name*

Last Name*
Ninth Yogi's Date of Birth*
Ninth Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Tenth Yogi's Name

First Name*

Last Name*
Tenth Yogi's Date of Birth*
Tenth Yogi's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Yogi's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
How would you evaluate your current health?*
Excellent
Good
Fair
Some Challenges

Please describe any injuries you have that may limit your full participation in the training.

Please list any medical conditions that may affect your ability to fully participate in the training.

How long have you been practicing yoga?

How many days per week do you practice?

Briefly describe your yoga experience.

Why do you want to take this course?

What inspires you?
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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