YOGA RELEASE FORM

All participants in yoga classes must have a completed release. Thank you!

Today's Date *
Today's Date
Name *
Name
Your Date of Birth *
Your Date of Birth
Mobile Phone Phone *
Mobile Phone Phone
Baby Date *
Baby Date
If pregnant, list your estimated due date. If postpartum, please list your youngest child's date of birth.
Please list any injuries, surgeries, illnesses or other conditions you feel the instructor should be made aware of:
Please describe any prior yoga experience (if any).
Please list name and relationship
Please include a phone number for your contact
Waiver *
I understand that classes may be physically strenuous and I voluntarily participate in them with full knowledge that of the risks that that may be present.
Participation *
I have my health care provider’s permission to begin prenatal or postpartum exercise. I have no contraindicative health issues that would prevent me from safely participating in a prenatal/postnatal fitness and yoga program.
Liability Release *
I release Everyday Miracles and its owners, employees, and agents, and will hold them harmless from any and all liability arising out of any personal injuries or damages, foreseeable or unforeseeable for me or my child, which may occur as a result of our participation in any class or program or activity sponsored by Everyday Miracles. I hereby declare myself and my child physically and mentally sound and capable of participation in those activities, programs, and I release Everyday Miracles and its owners, employees, and agents of any liability.
Photo Release *
I give permission to Everyday Miracles for use of any photos of me and my child for use in any marketing materials, website, or in other promotional manner.
Terms *
I understand that yoga class packages are nonrefundable and nontransferable unless otherwise stated. If I am unable to attend a date I have registered for, a minimum of 24-hour notice must be given in order to receive credit to apply to another date.