Liability Wavier

Lisa Kiss | Astrology, Mindfulness and Movement | Student Disclaimer Form

Date:

Name

Phone Number:

Address:

Email:

Birth Date

Body Injuries, Pain or anything to note:

I, agree to the following:

1. I am participating in the Yoga, mindful movement and meditation classes, or any other program offered with Lisa Kiss during which I will receive information and instruction about yoga, mindfulness, meditation, physical exercise or health. I recognize that exercise requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.

2. I understand that it is my responsibility to consult a physician prior to and regarding my participation in the yoga classes or workshops offered by my instructor. I represent and warrant that I am physically fit, and I have no medical condition, which would prevent my full participation in these yoga classes or workshops.

3. If I am pregnant, I understand that I participate fully at my own risk and that of my unborn child/children.

4. In consideration of being permitted to participate in the yoga classes or workshops, I agree to assume full responsibility for any risks, injuries or programs offered by my instructor.

5. In further consideration of being permitted to participate in the yoga classes or workshops, I knowingly, voluntarily and expressly waive any claim I may have against my instructor for injury or damages that I may sustain as a result of participating in these programs.

6. I understand that from time to time during yoga and meditation classes, the instructor may physically adjust students’ form and posture. If I do not want such physical adjustments, I will inform the instructor at each class I attend. I also acknowledge that if I do wish to receive such adjustments, it is my responsibility to inform the instructor when an adjustment has gone as far as I desire at that time.

7. I hereby take full and sole responsibility from any liability of loss or damage to personal property associated with yoga classes or any other events.

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above under my own free will. By booking into any Lisa Kiss Astrology, Mindfulness and Movement classes or accessing online material I hereby agree to the terms and conditions above. Upon booking any of our services you are confirming you indicate acceptance of our waiver.

Signature: