Yoga Student Waiver

Yoga Student Waiver

Fill out for virtual class participation
Name *

First Name Middle Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail
Phone Number *

Area Code Phone Number
Would you like to be included in Peace of Her Mind's monthly newsletter?
Would you like to be included in Peace of Her Mind's weekly text Remind? Yes please No thank you
Any yoga experience? Any medical restrictions/conditions? *
Answer here
Workout Disclaimer: I hereby consent I am voluntarily participating in yoga practice in-person and/or virtual yoga class (live or recorded) and I agree to assume all risks involved. I release Peace of Her Mind Yoga LLC, Tanya Coggin and/or YogaFaith from any injury, accident, or hazard related to yoga practice. I cannot hold Peace of Her Mind Yoga LLC, Tanya Coggin, and/or YogaFaith responsible for any liability. I recognize that any form of physical activity that I voluntarily participate in could be a potential risk, including risk of possible injury or even death. I hereby affirm that I am voluntarily participating in these activities whether in-person and/or virtual yoga classes with the knowledge of the risk involved. I agree to expressly assume and accept any and all risk of injury and/or death. I hereby affirm myself to be physically sound and suffering from no condition, ailment, impairment, disease, or other illness that would prevent my participation in in-person and/or virtual yoga classes. I've disclosed any medical issues related to participation. I affirm that I'm in physical condition to participate in class with Peace of Her Mind Yoga LLC, Tanya Coggin, and/or YogaFaith.* *
Type your name as digital signature
Click here if you agree. *

I agree to workout disclaimer.
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