Name _________________________________________

Address _______________________________________________________________

Phone ___________________ Email ___________________ Birthday ______________

AGREEMENT OF RELEASE AND WAIVER OF LIABILITY

I _____________________________ hereby agree to the following:

I am participating in yoga classes during which I receive information and instruction about yoga and wellness. I recognize that yoga 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 yoga classes. I represent and warrant that I am physically fit and I have no medical condition which would prevent my full participation in the yoga classes.

In consideration of being permitted to participate in the yoga classes, I agree to assume full responsibility for any risks, injuries, loss, or damages known or unknown, which I might incur as a result of participating in yoga classes or wellness programs offered by Bija Yoga and Wellness LLC.

In further consideration of being permitted to participate in the yoga classes, I knowingly, voluntarily and expressly waive any claim I may have against Bija Yoga and Wellness LLC and/or my yoga instructor or that I may sustain as a result of participating in their yoga classes or wellness programs.

I, my heirs, or legal representatives release, waive, and discharge Bija Yoga and Wellness LLC and/or my yoga instructor for injury, death, loss or damage arising out of use of or presence upon the facilities of Bija Yoga and Wellness LLC.

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.

__________________________________ ______________________
Signature of Participant Date