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Blue Jasmin Yoga Shala Waiver

921 E. Main Street Suite N 

Ventura, CA 93001

bluejasminyoga.com

WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT

BY CLICKING “I ACCEPT”, I ACKNOWLEDGE AND REPRESENT THAT I have read the following Waiver of Liability and Hold Harmless Agreement (this “Agreement”), understand it and understand that I am giving up rights under it, and agree to it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from this written Agreement, have been made; I am at least eighteen

(18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration the sufficiency of which I hereby acknowledge and I am fully intending to be bound by this Agreement.

1. In consideration for receiving permission to participate in the class or other activity for which I am making this reservation (the “Class”), I hereby RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation, the provider of the Class and each of their respective successors, assigns, affiliates, agents, officers, directors and employees and employers (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES or otherwise (including negligent rescue operations), while participating in such Class, or while in, on or upon the premises where the Class is being conducted.

2. I am fully aware of the unusual risks involved and hazards connected with participating in the Class, being in the air or on the water with the surrounding environment, and I represent that I am in good health and in proper physical condition to participate in the Class. I hereby elect to voluntarily participate in the Class with full knowledge that the activities may be hazardous to me. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF PERSONAL INJURY, INCLUDING DEATH, that may be sustained by me as a result of being engaged in such activity, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERWISE.

3. I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage or costs, including court costs and attorney fees, that they may incur due to my participation in said activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise.

4. I understand that RELEASEES may not maintain any insurance policies covering any circumstance arising from my participation in the Class. As such, I am aware that I should review my personal insurance portfolio.

5. I hereby acknowledge and agree that the releases set forth in this Agreement are intended to constitute a full mutual general release of claims and covenant not to sue, regardless of the existence or effect of any unknown, unsuspected, or unanticipated claim or fact. Consistent with that intention, I expressly, voluntarily, and knowingly waive, relinquish, and abandon each and every right, protection, and benefit to which I otherwise would or might be entitled now or at any future time under Section 1542 of the California Civil Code (and all similar provisions of law), which provides: “CERTAIN CLAIMS NOT AFFECTED BY GENERAL RELEASE. A GENERAL RELEASE DOES NOT EXTEND TO CLAIMS WHICH THE CREDITOR DOES NOT KNOW OR SUSPECT TO EXIST IN HIS OR HER FAVOR AT THE TIME OF EXECUTING THE RELEASE, WHICH IF KNOWN BY HIM OR HER MUST HAVE MATERIALLY AFFECTED HIS OR HER SETTLEMENT WITH THE DEBTOR."

6. It is my express intent that this Waiver of Liability and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE AND COVENANT NOT TO SUE the above-named RELEASEES. I hereby further agree that this Agreement shall be construed in accordance with the laws of the State of California and that if any portion of this Agreement is held invalid, that the balance shall continue in full force and effect.

7. I am fully aware if any equipment owned by Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation during the time I am utilizing it, is damaged or destroyed I am liable for replacing and/or full compensation for the damage. Any prior damage or wear and tear I am not liable for. All equipment will be assessed for damage at the time of returning from the rental, damage must be found at this time for you to be liable. Upon evaluation of damage a quote will be acquired and sent. I agree that I will operate the Yoga equipment in a reasonable and safe manner, so as not to endanger the lives of persons or property of any individual.

8. I hereby RELEASE AND DISCHARGE Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation and their owners, officers, directors, agents, employees, instructors and owners of equipment and the building or land used for Yoga activities from any and all liability, claims, demands or causes of action that I may hereafter have for injuries/damages arising out of my participation in Yoga activities, including, but not limited to, losses CAUSED BY NEGLIGENCE OF THE RELEASED PARTIES.

9. I hereby grant Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I understand and agree that all photos will become the property of Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation and will not be returned. I hereby irrevocably authorize Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photo. I hereby hold harmless, release, and forever discharge Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

10. I acknowledge the contagious nature of the Coronavirus/COVID-19 and that the CDC and many other public health authorities still recommend practicing social distancing.

I further acknowledge that Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation has put in place preventative measures to reduce the spread of the Coronavirus/COVID-19.

I further acknowledge that Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation cannot guarantee that I will not become infected with the Coronavirus/Covid-19. I understand that the risk of becoming exposed to and/or infected by the Coronavirus/COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, studio staff, and other clients and their families.

I voluntarily seek services provided by Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation and acknowledge that I am increasing my risk to exposure to the Coronavirus/COVID-19. I acknowledge that I must comply with all set procedures to reduce the spread while attending my class/workshop.

I attest that:

* I am not experiencing any symptoms of illness such as cough, shortness of breath or difficulty breathing, fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell.

* I have not traveled internationally within the last 14 days.

* I have not traveled to a highly impacted area within the United States of America in the last 14 days.

* I do not believe I have been exposed to someone with a suspected and/or confirmed case of the Coronavirus/COVID-19.

* I have not been diagnosed with Coronavirus/Covid-19 and not yet cleared as non contagious by state or local public health authorities.

* I am following all CDC recommended guidelines as much as possible and limiting my exposure to the Coronavirus/COVID-19.

I hereby release and agree to hold Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation harmless from, and waive on behalf of myself, my heirs, and any personal representatives any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself and/or property that may be caused by any act, or failure to act of the studio, or that may otherwise arise in any way in connection with any services received from Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation. I understand that this release discharges Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation from any liability or claim that I, my heirs, or any personal representatives may have against the facility with respect to any bodily injury, illness, death, medical treatment, or property damage that may arise from, or in connection to, any services received from Blue Jasmin Acupuncture, Herbs & Yoga Professional Corporation. This liability waiver and release extends to the facility together with all owners, partners, and employees.

FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)

AND, I THE MINOR’S PARENT AND/OR LEGAL GUARDIAN, UNDERSTAND THE NATURE OF PADDLESPORTS AND RELATED ACTIVITIES AND THE MINOR’S EXPERIENCE AND CAPABILITIES AND BELIEVE THE MINOR TO BE QUALIFIED, IN GOOD HEALTH, AND IN PROPER PHYSICAL CONDITION TO PARTICIPATE IN SUCH ACTIVITY. I HEREBY RELEASE, DISCHARGE, COVENANT NOT TO SUE, AND AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS EACH OF THE RELEASEE’S FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES, OR DAMAGES ON THE MINOR’S ACCOUNT CAUSED OR

ALLEGED TO BE CAUSED IN WHOLE OR IN PART BY THE NEGLIGENCE OF THE “RELEASEES” OR OTHERWISE, INCLUDING NEGLIGENT RESCUE OPERATIONS AND FURTHER AGREE THAT IF, DESPITE THIS RELEASE, I , THE MINOR, OR ANYONE ON THE MINOR’S BEHALF MAKES A CLAIM AGAINST ANY OF THE RELEASEES NAMED ABOVE, I WILL INDEMNIFY, SAVE, AND HOLD HARMLESS EACH OF THE RELEASEES FROM ANY LITIGATION EXPENSES, ATTORNEY FEES, LOSS LIABILITY, DAMAGE, OR ANY COST THAT MAY INCUR AS THE RESULT OF ANY SUCH CLAIM.

I Agree

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
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*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
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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