This form is an important legal document. It explains the risks you are assuming by beginning an exercise program. It is critical that you read and understand it completely. After you have done so, please print your name legibly and sign in the spaces provided at the bottom.

 

Waiver, Informed Consent, and Covenant Not to Sue. I have freely enrolled in Pregnancy Yoga exercise programme, under the direction of Nicola Saunders / Yoga By Nicola. Which will include, but may not be limited to,  yoga postures, breathing techniques, and relaxation. In consideration of Nicola’s agreement to instruct, assist, and train me, I do here and forever release and discharge and hereby hold Nicola/ Yoga By Nicola harmless from any and all claims, demands, rights of action, or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including any injuries resulting there from.

 

THIS WAIVER AND RELEASE OF LIABILITY INCLUDES, WITHOUT LIMITATION, INJURIES WHICH MAY OCCUR AS A RESULT OF 1) EQUIPMENT THAT MAY MALFUNCTION OR BREAK; 2) ANY SLIP, FALL, DRAPPING OF EQUIPMENT OR PROPERTY WITHIN PREMISES; AND 3) AILMENTS DURING/POST INSTRUCTION.

Assumption of Risk. I recognize that exercise might be challenging and that there could be dangers inherent in exercise for some individuals. I acknowledge that the possibility of certain accelerated physical and emotional changes during yoga therapy, yoga, and exercise does exist. I understand that as a result of my participation in herein programs I could suffer an injury. I recognize that an examination by a physician should be obtained prior to involvement in any exercise program. If I have chosen not to obtain a physician’s permission prior to beginning this exercise program with Nicola/ Yoga By Nicola, I hereby agree that I am doing so at my own risk. In any event, I acknowledge and agree that I assume the risks associated with any and all activities and/or exercises in which I participate. I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this program. I understand that results are individual and may vary.

 

I verify that I have been informed of the possible benefits and contraindicated conditions for yoga practice during pregnancy. I will discuss with my physician/certified prenatal healthcare provider any health concerns that he or she or I have about participating in yoga classes.

I further verify that I have noted on the above list all prenatal complications, risks or conditions I am/have experienced AND I have discussed it with my maternity healthcare provider.

I understand that I will be participating in Pregnancy Yoga sessions as a form of adjunctive health care only and that it is not a substitute for obstetric prenatal or perinatal care from a medical doctor or other licensed provider.

I hereby release and hold harmless and defend the practitioner from any claims, liability, demands and causes of action arising from my and my child’s participation in this class.

 

I ACKNOWLEDGE THAT I HAVE THOROUGHLY READ THIS WAIVER AND RELEASE AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. BY SIGNING THIS DOCUMENT, I AM WAIVING ANY RIGHT I OR MY SUCCESSORS MIGHT HAVE TO BRING A LEGAL ACTION OR

ASSERT A CLAIM AGAINST Nicola Saunders / Yoga By Nicola.

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