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Participation Intake Form

Agreement of release and waiver of liability


(parent or guardian if under 18)   hereby agree to the following:

That I am participating in classes offered at The Mat during which I receive information and instruction about various forms of exercise and health.  I recognize that participation in classes at The Mat requires physical exertion, which may be strenuous and may cause physical injury and I am fully aware of the risks and hazards involved.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the classes at The Mat.  I represent and warrant that I am physically fit and I  have no  medical condition which would prevent my full participation in the classes.

In further consideration of being permitted to participate in classes at The Mat, I knowingly, voluntarily and expressly waive any claim I may have against The Mat or my instructor or that I may sustain as a result of participating in any program offered at The Mat.

I, my heirs, or legal representatives forever release, waive, discharge and covenant not to sue The Mat and/or my yoga instructor for any injury or death caused by their negligence or other acts.

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.  

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