Yoga Circle Studio

707 Pine Ave. #A103

Snohomish, WA. 998290

INFORMATION & WAIVER OF LIABILITY

Name:__________________________________________		Birth Date:________________		M ______  F __________
Address:_______________________________________		City:_________________		Zip: _____________
Hm Phone:________________	Wk Phone:___________________		Mobile:_____________________
Email: ________________________________________________________________________________
Emergency Contact Name: _________________________  Phone: ______________________________
Referred to Yoga Circle Studio by: ________________________________________________________
How did you hear about Yoga Circle Studio? _______________________________________________
What times work best for you for Yoga or Pilates classes?____________________________________

READ BEFORE SIGNING BELOW:

I fully appreciate, understand, and acknowledge the fact that yoga, Pilates, or Tai Chi may be strenuous and that there exists certain inherent risks and hazards. I choose to voluntarily participate in instructional sessions at Yoga Circle Studio, and by participating, assume, in any programs offered by Yoga Circle Studio, full responsibility for all risks. If I observe any undue stress or pain during my participation, I will remove myself from participation and bring this situation to the attention of the nearest teacher.

    I understand that if I have health concerns, it is my responsibility to consult with my health care practitioner prior to my participation in any programs offered at Yoga Circle Studio. I assume full responsibility for my participation.

Terms and conditions of participation:

· If I eat before class, I will eat lightly. (We recommend that you drink at least 8 oz. of water after class.)

· I will arrive on time.

· I will turn off cell phones and pagers.

· I will wear non restrictive clothing, and avoid perfumes and scented lotions.

· I will tell my teacher about existing injuries, conditions, or limitations that might affect my practice.

· I understand that fees for class cards are nontransferable and nonrefundable.

· I understand that Drop In or Series class cards expire as stated at the time of purchase.

I willingly agree to comply with the above stated terms and conditions for participation.

By signing below I release Yoga Circle Studio, as well as their agents, tenants, managers, individual person, and damage or loss to my property incurred while on the premises at 707 Pine Avenue Unit A103, Snohomish, WA 98290.

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

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