Health & Fitness Liability Waiver / Informed Consent Form
I have voluntarily enrolled in the health and fitness program known as Body Love Yoga. I recognize that I am fully responsible for my self care and body self awareness.
I recognize that the program may involve strenuous physical activity including, but not limited to, stretching, muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities and stretches. I hereby affirm that I am in good physical condition and do not have any known disability or condition which would prevent or limit my participation in this exercise program.
Should I have a disability or condition that would prevent or limit my participation, I affirm that I have discussed with my physician before beginning this exercise program. I hereby affirm that I have worked with my healthcare professional to design an appropriate exercise prescription.
If I experience any pain or difficulty with these exercises, I will stop and consult my healthcare provider. If I experience any symptoms of weakness, unsteadiness, light-headedness or dizziness, chest pain or pressure, nausea, or shortness of breath, I will stop and consult my healthcare professional.
I understand that mild soreness after exercise may be experienced after beginning a new exercise. If the soreness does not improve after 2-3 days I will consult my physician.
In consideration of my participation in this program, I hereby release Anna Chapman aka Anna Chapman, Body Love Yoga LLC, The Gem and their agents, the company, its insurers, employees, officers, directors, and associates, from any and all claims, demands, damages, rights of action, or causes of action, present or future, whether the same be known or unknown, anticipated, or unanticipated, resulting from or arising out the participation in said program, equipment and facilities as a result of my voluntary participation and enrollment.
I acknowledge that my enrollment and subsequent participation in purely voluntary. I fully understand that I may injure myself as a result of my enrollment and subsequent participation in this program. I accept and assume full responsibility for any and all injuries, damages (both economic and non-economic), and losses of any type, which may occur to me or my guests and I, hereby fully and forever release and discharge Anna Chapman aka Anna Chapman, Body Love Yoga LLC, The Gem and their agents from any liability now or in the future for conditions that I may obtain. These conditions may include, but are not limited to, heart attacks, muscle strains, muscle pulls, muscle tears, broken bones, shin splints, heat prostration, injuries to knees, injuries to back, injuries to foot, or any other illness or soreness that I may incur, including permanent disability and death.
I agree to be solely responsible for my safety and well being. I understand that the group exercise experience does not provide direct supervision, instruction, or assistance for exercise.
I HEREBY AFFIRM THAT I HAVE READ AND FULLY UNDERSTAND THE ABOVE STATEMENTS AND VOLUNTARILY SIGNED THIS WAIVER WITH FULL KNOWLEDGE OF ITS CONTENT.