Name *

First Name

Last Name

By signing this Agreement, I am aware that I am waiving certain legal rights and am free to seek legal advice before signing. I have read this Agreement carefully. I agree to the following: *

All terms are required to participate.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any Yoga Class.

I recognize that Yoga is a physical activity which may cause physical injury or exacerbate an underlying medical condition or injury I already have.

I am fully aware of the risks and/or hazards involved and unconditionally and freely accept this and agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in any Yoga Class.

I , my heirs, next of kin, Executors, Estate Trustees, Administrators, assigns and representatives forever release, waive and discharge Aging with Yoga and/or Anna Chiandet from any and all liability, claims or demands that may arise out of or as a result of my participating in any Yoga Class, including negligence on the part of the Aging with Yoga and/or Anna Chiandet.

Further, I agree to hold harmless and indemnify Aging with Yoga and/or Anna Chiandet, her heirs, next of kin, assigns and representatives from any and all liability which may arise out of or result from for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in any Yoga Class.

I have read the above and fully understand its contents. I am 18 years of age or older and voluntarily agree to the terms and conditions stated above.

Date *

MM

DD

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