Name *

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Address *

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General Liability *

Below you consent to practice yoga virtually and in person at SHABBHAKTI

I waive and release SHABBAKTI, its agents, contractors, employees, officers, and directors (hereinafter, collectively, SHABBHAKTI), from and against any and all claims, demands, expenses, causes of action, lawsuits, damages, and liabilities, of every kind and nature provided that the Claims do not arise from acts of gross negligence or intentional, willful or wanton misconduct.

As is the case with any physical activity, there exists an inherent risk of serious injury, including death, that is always present and cannot be entirely eliminated. By signing below, I acknowledge that participation in yoga classes, events, or other activities conducted by, offered by or on the premises of SHABBHAKTI (hereinafter, collectively, Yoga Classes) exposes me to a potential risk of such personal injury. I am fully aware of this risk and knowingly and voluntarily, on behalf of myself, my heirs assign, next of kin and legal representatives, waive, release SHABBHAKTI from and assume full responsibility for all Claims.

I understand that it is my responsibility to consult with a physician prior to and regarding participation in Yoga Classes) I represent and warrant that I (or any minor child who is the subject of this Waiver and Release) am physically fit to participate in Yoga Classes and have no medical or other physical condition that would prevent full participation in yoga classes. If I am pregnant or become pregnant or am post-natal, my signature confirms that I am participating in Yoga Classes with my doctor’s full approval.

Covid-19 Release *

Below you consent to follow the CDC guidelines for best practices regarding COVID-19, also known as coronavirus.

Neither I nor anyone in my household had the following symptoms over the last 72 hrs and should that change, I agree to notify SHABBHAKTI and stop coming to classes.

I will agree to adhere to social distancing protocols and instructions enacted by SHABBHAKTI in classes I participate in per the’ instructions to maintain a 6-foot distance from other students and teachers and follow all other protocols enacted by the studio. If not, I acknowledge that the teacher may ask me to leave the facility.

By signing this form, I agree to adhere to Covid-19 CDC guidelines that SHABBAHKTI has put in place and I will not hold SHABBHAKTI liable for any sickness, illness, or exposure, including but not limited to Covid-19.

Video/Photo Release *

You consent to the use of your image on social media or our website in video or photography.

Option One

Option Two