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Please list health impairments, injuries, surgeries, etc.
If new to Yoga, what are your interests, concerns or questions? If you practice, please share how long and practice of yoga.
I, the undersigned, hereby carefully read, understand and agree to the following terms, conditions, waivers and releases:
- I am participating in a Yoga Workshop (the “Workshop”) offered and taught by Jill Knouse Yoga, LLC, her teachers, employees, and agents (collectively “Jill Knouse Yoga”) during which I will receive information and instruction about several topics, including but not limited to physical movement, exercise, yoga and health. I recognize that these activities require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
- I understand and fully accept that it is my responsibility to consult with a physician prior to and regarding my participation in the Workshop. I represent and warrant that I am physically fit and I have no medical conditions that would prevent my full participation in the Workshop.
- I acknowledge that I shall inform Jill Knouse Yoga of any injury or condition that might alter my ability to participate, and to inform Jill Knouse Yoga immediately if any injury occurs during the Workshop.
- I, my heirs, or legal representatives, do hereby waive and release Jill Knouse Yoga from any and all liability and responsibility from injury, accident, illness, legal and medical fees sustained now or in the future from my participation in any activity or use of facilities during the Workshop.
- I agree that Jill Knouse Yoga is not responsible for the loss or damage of my personal property during the Workshop.
- I understand that Jill Knouse Yoga requires everyone to be respectful and professional, and Jill Knouse Yoga reserves the right to request anyone to leave the facilities immediately and cancel further participation should Jill Knouse Yoga deem my involvement in any unprofessional conduct. In such case, any fees for the Workshop will not be reimbursed.
- I acknowledge that I may not use any type of recording device, photography, or videography to capture the information provided at the Workshop for a pecuniary benefit without Jill Knouse Yoga's explicit written consent.
- I consent to Jill Knouse Yoga using any photograph, image, recordings or audio of my name, likeness, voice, biographical details, or testimonial taken during or in relation to the Workshop for marketing, advertising or any other purpose in any media now or hereafter without further compensation, permission, or notification.
- These Terms will be governed by and construed in accordance with the laws of the State of Oregon.
- I agree that any dispute that arises out of or relates to these Terms will be resolved via non-binding mediation in the State of Oregon via a professional mediator obtained by Jill Knouse Yoga and if a successful mediation is not reached, to binding arbitration in the State of Oregon in accordance with the policies set forth by the Arbitration Service of Portland.
BY SIGNING THIS AGREEMENT I UNDERSTAND AND AGREE TO ALL OF THE ABOVE TERMS, CONDITIONS, WAIVERS AND RELEASES.
Please sign your full name within the box using either your mouse or your finger on a touchscreen / touchpad.
We look forward to your presence. THANK YOU!