* Phone Number
* Emergency Contact
Emergency Contact Number
* Emergency Contact Number
Any dietary restrictions?
Any allergies or sensitivities?
How may we support you at this retreat?
What are you looking for from this retreat?
Any ailments or injuries?
If at any time during the class, you feel discomfort or strain, gently come out of the posture. You may rest at any time in the class. It is important in yoga that you listen to your body and respect its limits at any given moment.
I, the undersigned, understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment. I should consult a physician prior to beginning any activity program, including yoga. I recognize that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I will not perform any postures to the extent of strain or pain.
In further consideration of being permitted to participate in the yoga classes, I knowingly, voluntarily and expressly waive any claim I may have against the instructor, the owner or the leaseholder of the building for injuries or damages that I may sustain as a result of participating in classes or workshops led by Samantha Tran.
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. Those under 18 years of age must have this form signed by a parent/guardian.
By checking the box "I agree", you are agreeing to the terms of the waiver.
I do not agree