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Revitalizing your life! Having fun while doing it!

Traversing Mind, Body, and Soul!

#traversesyoga

I hereby agree to the following:

I am participating in classes or services during which I will receive information and instruction about yoga and health. I recognize that yoga requires physical exertion, which may be strenuous and cause physical injury and I’m fully aware of the risk hazards involve.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any physical activity or fitness program, including yoga. I represent and acknowledge that I have no medical condition that may or would prevent my participation in yoga, physical activities or any other activities.
 In consideration of being permitted to participate in the yoga classes, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which I might incur as a result of participating in the program.
 Further consideration of being permitted to participate in these yoga classes, I knowingly and voluntarily waive any claim I have against the instructor(s), owner(s) or the leaseholder of the building/property and they are not legally or financially responsible for any injuries or damages that may occur as a result of participating in these yoga classes.

I have read the above statements of the waiver and liability and fully understand its  contents. I voluntarily agree and consent to the above terms and conditions

PHOTOGRAPHY: I further give permission and consent to allow photographs taken during class of my likeness to be published and used by Tessa Jones to illustrate and promote the yoga event experience and its other programs. This may inculde use on public social media platforms, promotional materials, and program websites. Photos will only be published and used without identifying the participant by name. 

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*
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.
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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