Name *

First Name

Last Name

Are you pregnant?

Yes

No

Please read the following AGREEMENT OF RELEASE and WAIVER OF LIABILITY carefully before signing: (required) I understand and acknowledge the fact that in yoga, as in other forms of exercise, sports, bodywork, or self-development, there exist certain inherent risks. I voluntarily participate in the yoga instruction provided by TLC Yoga teachers and assume all responsibility for all risks, injuries, or damages, known or unknown, which I might incur as a result of participating in the yoga program. I understand that it is my responsibility to consult with my health care practitioner prior to and regarding my participation in yoga classes, By signing below, I release Brianna Whitfield, Ashley Erwin, Terica Johnson-Stewart, Radiant Flow Yoga, TLC Yoga & Bridge of Light, volunteers, staff & other students from liability, and hold them harmless for any injury to my person, and damage or loss to my property incurred, whether caused in or out of class, by negligence or otherwise. *

Yes

No

I have read, understood and agreed to the policy on this registration form: *

Yes

No

I understand that by entering my initials in the field below, I am effectively providing my signature, indicating that all the information on this form is true and accurate, to the best of my knowledge. *

Yes

No