NIMASTE YOGA, LLC
MEMBER INFORMATION AND WAIVER OF LIABILITY AGREEMENT
RELEASE OF LIABILITY & PARENT/GUARDIAN’S AGREEMENT/AUTHORIZATION/RELEASE:
I, Member, have volunteered to participate in Nimaste Yoga, LLC’s (Nimaste Yoga) yoga, reiki, and/or any other classes or programs of physical exercise (together `the Class”). I understand that there is an inherent risk associated with any exercise program that may result in injury, even serious or disabling, or death, and that this risk is always present and cannot be entirely eliminated. I represent that I am in good health and have no disability, impairment, injury, disease, or ailment, preventing me from engaging in active or passive exercise or which could cause increased risk of injury or adverse health consequences as a result of exercise. I affirm that I have disclosed any and all physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in the Class. I assume the responsibility to update Nimaste Yoga of any changes in my medical condition now or in the future that might affect my safety or participation in the Class prior to the commencement of any such Class, and I understand that Nimaste Yoga shall not be liable should I fail to do so. If I am pregnant or become pregnant or am post-natal, my agreement here verifies that I am participating in the Class with my doctor’s full approval. I HEREBY VOLUNTARILY AND EXPRESSLY ASSUME THE RISKS INHERENT IN MY PARTICIPATION IN THE CLASS, INCLUDING THE RISK OF INJURY, ACCIDENT, DEATH, LOSS, COST OR DAMAGE TO MY PERSON OR PROPERTY.
I, individually and on behalf of my child/ward, for any and all heirs and personal representatives, do hereby release and forever discharge Nimaste Yoga, as well as individuals and entities related to Nimaste Yoga, including but not limited to members, employees, trustees, contractors, volunteers, representatives, agents, and successors, and anyone else acting for or on its behalf, and the owner/lessor of the premises, or anyone using the Nimaste premises whether related to the Class or not (collectively referred to herein as “Nimaste Yoga”) from any and all liability, claims, obligations, debts, demands, actions, rights of action, suits, accounts, covenants, contracts, agreements, and damages whatsoever of every name and nature, both in law and equity, which I now have or in the future may have relating to, occurring during, or arising out of, any injury sustained by me or my child as a result of his/her participation in the Class.
I hereby forever irrevocably waive, release, and discharge Nimaste Yoga from any and all or of any kind related to, arising from, or in any way connected with, my participation in the Class or any other programs offered or sponsored by Nimaste Yoga or attending Nimaste Yoga related events, both on and off of the Nimaste Yoga premises. This Release and Waiver applies to all claims, foreseen or unforeseen, including negligence and breach of statutory or other duty of care. This Release and Waiver includes, without limitation, injuries which may occur as a result of equipment that may malfunction or break; any slip or fall within premises; and ailments during and/or post Class instruction. I UNDERSTAND THAT I HAVE FORFEITED MY RIGHTS TO SUE NIMASTE YOGA, AND THAT THIS IS A RELEASE OF LIABILITY THAT IS VALID FOREVER.
I understand that Nimaste Yoga does not diagnose illness, disease or any other mental or physical disorder, or prescribe medical treatment of pharmaceuticals. I understand and acknowledge that Nimaste Yoga is providing non-medical services, and the Class is not a substitute for medical attention, diagnosis or treatment and that it is recommended that I see a medical practitioner for any physical ailment that I may have.
I authorize the staff of Nimaste Yoga to obtain medical/hospital treatment for the above participant(s) in the event of an emergency. I hereby and represent that if the participant is a minor, I am his/her parent/guardian and authorized to provide the releases, authorizations, and permissions stated herein and all the information provided is accurate and complete. I hereby give permission for the participant named above to participate in the Class.
I hereby irrevocably grant Nimaste Yoga the unrestricted right to use my name, appearance, image, likeness, voice, picture and/or personal story (together my “Likeness”) in any manner in connection with its business (including without limitation for purposes of advertising and trade). Nimaste Yoga shall have the unrestricted right to any photograph in which I appear while participating in activities at the Nimaste Yoga facility. I release my rights of publicity, editorial rights, or other rights with respect to my Likeness in connection with Nimaste Yoga's business and acknowledge I will not receive any compensation for the use of my Likeness.
PLEASE READ CAREFULLY. THIS RELEASE OF LIABILITY CONTAINS A RELEASE OF KNOWN AND UNKNOWN CLAIMS BY YOU AND YOUR CHILD. I RECOGNIZE THAT BY AGREEING TO THIS DOCUMENT, I AM WAIVING CERTAIN LEGAL RIGHTS, INCLUDING ANY RIGHT I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MIGHT HAVE TO BRING A LEGAL ACTION OR ASSERT A CLAIM AGAINST NIMASTE YOGA. I INTEND FOR MY AGREEMENT TO BE A COMPLETE AND UNCONDITIONAL RELEASE OF LIABILITY OF NIMASTE YOGA TO THE GREATEST EXTENT PERMITTED BY LAW.BY SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THIS RELEASE OF LIABILITY, AND KNOWINGLY AND VOLUNTARILY AGREE BELOW.