Informed Consent
This Agreement is intended to provide the client listed above (Herein the “Student”) with important information regarding the practices, policies, and procedures of Dena McComb (herein the “Teacher”), and to clarify the terms of the professional relationship between Teacher and Student.
Any questions and concerns regarding the contents of this Agreement should be discussed with Dena McComb prior to signing it.
The Student understands that yoga includes physical movements as well as an opportunity for relaxation, stress reeducation and relief of muscular tension. Participation in yoga class includes, but is not limited to, participation in meditation techniques, yogic breathing techniques, and performing various yoga postures.
Yoga postures, or asanas, are designed to exercise every part of the body―stretching and toning the muscles and joints, the spine and the entire skeletal system. They also work on the internal organs, glands and nerves. Yoga incorporates sustained stretching to strengthen muscles and increase flexibility.
Yoga is an individual experience.
As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. The Students signature acknowledges that the Student understands that in yoga class the Student will progress at students own pace. If the student experiences any pain or discomfort, the student will listen to the students body, adjust the posture and ask for support from the the Teacher.
The student will continue to breathe smoothly. If at any point the student feels overexertion or fatigue, the student will respect the students body’s limitations and the student will rest before continuing yoga practice.
Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. The student affirms that the student alone is responsible to decide whether to practice yoga.
By signing below, the student acknowledges that participation in yoga classes exposes the student to a possible risks of personal injury. The student is fully aware of this risk and hereby consents to receive medical treatment that may be deemed advisable in the event of injury, accident and/or illness during any yoga class.
The student hereby takes action for the students self, my executors, administrators, heirs, next of kin, successors and assigns as follows:
(a) I irrevocably WAIVE, RELEASE AND DISCHARGE FROM ANY AND ALL LIABILITY for my death, disability, personal injury, property damage, property theft or actions of any kind which hereafter may occur to me, including my traveling to and from yoga classes, the Teacher who is hosting these classes and where sessions are being held, and each of their directors, officers, employees, volunteers, representatives and agents; and
(b) INDEMNIFY, HOLD HARMLESS AND AGREE NOT TO SUE the entities or persons mentioned in this paragraph as to any and all liabilities or claims made as a result of participation in the yoga classes, whether caused by the negligence of releasees or otherwise.
My signature further acknowledges that I shall not now or at any time in the future bring any legal action against Teacher and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns.
My signature verifies that I am physically fit to participate in yoga classes and a licensed medical doctor has verified my physical condition for participation in this type of class.
If I am pregnant or become pregnant or am postnatal, my signature verifies that I am participating in yoga classes with my doctor’s full approval. I realize that I am participating in yoga classes at my own risk.
The Student Waiver Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law. I acknowledge that this Student Waiver Agreement form will be used by the persons or entities being released in the yoga classes and that it will govern my actions and responsibilities in said classes.
