Name
*
First Name
Last Name
Please list the main reasons you desire private yoga instruction:
*
What goals can I help you work towards during our private lessons? (physical, mental, emotional, spiritual, etc.)
*
Prior yoga experience (number of years, type of practice, etc.):
*
Are you involved in regular exercise or sports? If yes, please describe:
*
Are you under the care of a medical professional or health care provider?
*
Yes
No
If yes, for what? (If no, please write "N/A")
*
Have you had any accidents or injuries, hospitalization or surgeries? If yes, please list (if no, please write "N/A"):
*
Are you pregnant
*
Yes
No
Maybe
Waiver of Liability & Cancellation Policy
*
I hereby agree to the following:
1. I am participating in yoga classes (the “Activities”) offered by Madi Cooper (the“Teacher”). The Activities may be
offered in the physical location of the Studio or offered online by videos, television, podcasts, apps or other digital media or platforms. All of such offerings, either physical or online, shall be considered “Activities.”
2. I recognize that I must be in adequate physical and mental health to participate in the Activities. I understand that the Activities may require intense physical exertion, and I represent and warrant that I am physically fit enough to participate, and I have no medical condition which would prevent my full participation in the Activities. I recognize that the Activities may cause or aggravate a physical injury or medical condition. I understand that it is my responsibility to consult with a physician before my participation in the Activities. If I have done so, I have taken the physician’s
advice. I understand that the Teacher reserves the right to refuse my participation in any Activity on medical, fitness or any other grounds.
3. I am aware that my participation in the Activities could result in high blood pressure, fainting, heartbeat disorders, physical injury, heart attack or stroke and may aggravate pre-existing injuries. I understand that I could experience muscle, back, neck and other injuries as a result of my participation in the Activities. I understand my physical limitations and I am sufficiently self-aware to stop or modify my participation in any Activity before I become injured or aggravate a pre-existing injury.
4. In consideration of being permitted to participate in the Activities, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the Activities, including those which may result from the negligence of the Teacher.
5. In further consideration of being permitted to participate in the Activities, I knowingly, voluntarily and expressly waive any “Claim” (as defined below) I may have against the Teacher and any of Teacher’s employees, independent contractors or assistants (each, a “Released Party”) that I may sustain as a result of participating in the Activities even if the Claim arises from the negligence of Released Party or anyone else.
I agree to indemnify and hold harmless Released Party from any loss, cost, or liability incurred in defending any Claim made by me or anyone making a Claim on my behalf, even if the Claim is alleged to or did result from the negligence of Released Party or anyone else.
“Claim” includes but is not limited to any and all liabilities, claims, demands, expenses, fees, legal actions, rights of actions for damages, personal injury, mental suffering and distress, or death that I may suffer, my spouse, children or unborn child may suffer (including any legal fees or expenses) in connection with participation in any Activity.
6. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue any Released Party for any Claim caused by any negligence or other acts of any Released Party.
7. I hereby understand that the Teacher from time to time may photograph, video, or otherwise record Activities and place such photographs and videos on its Website or social media platform. I hereby consent to the use of my image that may appear in any such photograph or video.
8. This agreement shall be construed in accordance with, and governed by, the laws of the State of Utah and that all actions, suits, claims and proceedings relating to this agreement shall be brought in a court of competent jurisdiction
located in Salt Lake City. In case any provision of this agreement shall be held invalid, illegal or unenforceable, it shall not affect any other provision of this agreement and this agreement shall be construed as if such provision had
never been contained herein.
CANCELLATION POLICY:
Private yoga classes: I understand and acknowledge the 24-hour cancellation policy for private classes. I understand and acknowledge that full payment will be charged if a private session is cancelled with less than 24-hour notice. I understand and acknowledge that cancellation or rescheduling of a private class prior to 24-hours before the appointment will be refunded or kept on my account. I understand and acknowledge if I am late for a private class, that the class will end at the original, scheduled time.
Private yoga events: I understand and acknowledge the 24-hour cancellation policy for private yoga events. I understand and acknowledge that full payment will be charged if a private yoga event is cancelled with less than 24-hour notice. I understand and acknowledge that private yoga event deposits are refundable up to 7 days in advance of the event. I understand and acknowledge if I, or my party, am late for a private yoga event, that the class will end at the original, scheduled time.
I acknowledge that I have carefully read this agreement and fully understand its contents. I voluntarily and knowingly agree to the terms and conditions stated herein. I am aware that by signing this agreement, I am giving up substantial rights, including my right to sue and certain legal rights my heirs, next of kin, executors, administrators and assigns may have against any Released Party.
I have read and agree to the terms above