Utah Prenatal Yoga: Teacher Training Registration Form & Release of Liability

I am aware and fully understand that Utah Prenatal Yoga is operated to help me gain knowledge of yoga. I understand yoga can be strenuous and may involve physical exertion which may involve the risk of injury. Utah Prenatal Yoga will take reasonable measures to prevent injury, but I understand there are always risks. I understand that I am responsible for knowing my own limitations with regard to yoga. I know of no medical reason for not practicing yoga. I agree to take full responsibility for practicing yoga within my physical boundaries. I agree to take full responsibility for any injury I, or any minor accompanying me, may suffer during the practice of yoga with Utah Prenatal Yoga. I agree to inform the instructor immediately if any injury occurs to myself or another during yoga instruction. I understand that practicing yoga may involve physical adjustments from instructors occasionally. If I do not want adjustments from the instructor, it is my responsibility to notify him/her before the start of the instruction. If I do wish to receive adjustments, I understand it is my responsibility to notify the instructor when the adjustment has gone as far as desired. I understand that the Utah Prenatal Yoga Teacher Training Manual is protected by copyright and cannot be reproduced, reprinted, distributed, shared or used for any other purpose other than for my personal reference. I understand that the content of the manual is in no way a form of medical advice and that any action I take based on the content of the training material is my sole responsibility. I hereby waive and release any claim that I may have at any time for injury of any kind against Utah Prenatal Yoga, LLC or any person or entity involved therewith, including but not limited to its members, managers, instructors, employees, agents, representatives, locations or hosts. I hereby waive and release any claim that I may have at any time for injury of any kind to any minors or individuals under 18 years of age that attend class or instruction with Utah Prenatal Yoga while in my care. I hereby consent and agree to grant all rights to photographs or videos taken of me, or of any minor accompanying me, during class or instruction to be used by Utah Prenatal Yoga, LLC for unrestricted personal or commercial use and reproduction. All equipment and services of Utah Prenatal Yoga are subject to change or deletion at the discretion of the Utah Prenatal Yoga, LLC. This release shall be binding upon me and my heirs, legal representatives, and assigns.

I have carefully read and understand the above Release of Liability and I agree to the above by signing below.

Name

First Name

Last Name

Date

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Birth Date

YYYY

Known Health Issues

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####