Name *

First Name

Last Name

Phone

(###)

###

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Have you practiced yoga before?

Yes

No

Please read the following AGREEMENT OF RELEASE and WAIVER OF LIABILITY carefully before signing: *

I understand and acknowledge the fact that in yoga, as in other forms of exercise, sports, bodywork, or self-development, there exist certain inherent risks. I voluntarily participate in the yoga instruction provided by Your Yoga Roadie (online or in person) or in private sessions and assume all responsibility for all risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the yoga program. I understand that it is my responsibility to consult with my health care practitioner prior to and regarding my participation in yoga classes, By signing below, I release Your Yoga Roadie & Ashley Erwin, all teachers and other students from liability, and hold them harmless for any injury to my person, and damage or loss to my property incurred, whether caused in or out of class, by negligence or otherwise. If meeting in person, I know that yoga requires alignment of the body and that yoga teachers often adjust students to help them get into the poses more accurately. By signing below I consent to such touch and adjustment. If I do not wish to be touched, I will clarify that fact in a signed writing and hand it to the teacher, prior to commencement of class.

Yes

No

I have read, understood and agreed to the policy on this registration form: *

Yes

No

I understand that by entering my initials in the field below, I am effectively providing my signature, indicating that all the information on this form is true and accurate, to the best of my knowledge. *

Yes

No