Informed Consent Form
Please read before logging onto a session. Logging onto/attending session is consent to terms of waiver for all participants. Children in attendance must be accompanied by adult who reads and agrees to this waiver on their behalf.
As pertains to services rendered by REBECCA QUIGLEY and Every Day Is Yoga (EDIY). This waiver applies to online or in-person group or private individual classes as well as Collaborative Care Yoga.
I understand that yoga includes physical movements as well as an opportunity for relaxation, stress reduction and relief of muscular tension. I realize I will receive information and instruction; including verbal and physical adjustments to avoid injury and improve alignment. You are always welcome to opt for verbal-only adjustments. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. I understand that it is my responsibility to consult with a physician prior to my participation in the yoga class.
I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in the private yoga class. I am aware I may be physically adjusted with my consent and I agree to take full responsibility for any risks, loss, claim, injury, damage or liability, known or unknown, which I might incur as a result of participating in the program.
If I am pregnant, I take full responsibility for obtaining medical clearance for the practice of yoga. I will disclose my pregnancy to REBECCA QUIGLEY & EDIY so that the practice may be adjusted accordingly. However, I fully understand and accept that neither REBECCA QUIGLEY, nor any member of EDIY is a medical professional and I will not hold REBECCA QUIGLEY or EDIY legally or financially responsible for any ill-effects or injuries sustained from the act of participating in yoga lessons or from practicing yoga sequences prepared for me at home. I will always inform REBECCA & EDIY if my doctor has prohibited any type of movement, so that it can be excluded. I am fully responsible for myself, my unborn child, and both of our well-beings.
Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. I affirm that I alone am responsible to decide whether I practice yoga. I knowingly, voluntarily and expressly agree to accept full responsibility and assume the risk for my use of or participation in any and all classes, activities, apparatus, appliance, facility, of any nature, which is owned or operated by REBECCA QUIGLEY & EDIY. While engaging in private yoga with REBECCA QUIGLEY & EDIY. I shall do so at my own risk and hold REBECCA QUIGLEY & EDIY, her employees, representatives and agents, forever harmless from any and all loss, claim, injury, damage or liability sustained or incurred by me. I specifically agree to indemnify and hold harmless REBECCA QUIGLEY & EDIY to any loss, cost, claim, injury, damage or liability, sustained or incurred by participating in the classes, or through my use of her facilities or equipment, which is caused by an act or omission, whether negligent, intentional or otherwise, of an employee, representative or agent of REBECCA QUIGLEY & EDIY.
I, my heirs or legal representatives forever release waive, discharge and covenant not to sue REBECCA QUIGLEY & EDIY for any injury or death caused by my participation in the yoga class. My signature below constitutes my full acceptance of this waiver.
I have read the release and waiver of liability and fully understand its consent. I voluntarily agree to the terms and conditions stated above. An electronic signature in the form of a typed font is considered legally binding. A printed copy will be brought to the first lesson for a handwritten signature as well!
If the participant is a minor child, under the age of 18 years, this document must be agreed to and signed by a responsible party, being a parent or guardian. As the parent/guardian of said minor child, I agree to all of the above on legal behalf of said minor child. I also agree to accompany minor child participants at all times during yoga practice. I take full responsibility for relaying any and all physical, mental, or emotional concerns of the minor child which may affect a yoga practice. If I am unsure of what would affect yoga practice, it is my sole responsibility to disclose any physical, mental, or emotional issues. I, and only I will take responsibility for the safety and well-being of my child. I will not hold REBECCA QUIGLEY or any employee of EDIY responsible for any aspect of my child’s safety or well-being.