Love Roots Yoga Shala Cooperative LLC

PO Box 2777

Wrightwood, CA 92397-2777

Waiver of Liability and Disclosure Form

Before class, please read, initial, and sign the form below.

1. I understand there is an inherent risk associated with any exercise program, including my voluntary participation in yoga, dance, and fitness classes, that may result in injury. The exercises related to yoga and the above mentioned classes will challenge my cardio-respiratory and musculoskeletal systems associated with the aerobic, strength, power, agility, flexibility, and breathing components of the program. I understand and am aware that the components of exercise/yoga are potentially hazardous activities and may cause injuries.

2. I understand that I may receive physical assists or adjustments to enhance or correct my body posture during class by either the instructor or an assistant in class. I will take accountability for letting the teacher and/or assistant know of any injuries or impairments in advance before class begins or if I do not want to receive any assists or adjustments.

3. I have decided to participate in an exercise program voluntarily and with or without the approval of my physician and do hereby assume all responsibility for my participation in any exercise/yoga class or activity associated with Love Roots Yoga Shala Cooperative LLC.

4. I certify that I am physically well and suffering from no medical problems, conditions, impairments, diseases, or other illnesses that would prevent my participation or increase my risk of injury and/or illness as a result of partaking in any exercise/yoga program/class/activity.

5. I, my heirs, or legal representatives, do hereby waive and release Love Roots Yoga Shala Cooperative LLC and its teachers, assistants, building owners, and employees from any and all liability and responsibility from injury, accident, illness, legal fees, and medical fees sustained now or in the future resulting from my participation in any activity or use of equipment.

6. I understand Love Roots Yoga Shala Cooperative LLC is in no way responsible for the loss or damage of any of my belongings while I attend class.

If participant is under 18: As legal guardian of this participant, I consent to the above terms and conditions.