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Yoga Participant Waiver Form

I hereby consent as a participant in any yoga classes and agree to assume all of the risks involved. I understand that Whitney R. Simpson/Exploring Peace DBA Bloom Yoga Studio does not provide medical insurance relative to accidents, injuries, and/or death as a result of program related activities; and that I can not hold her or our class location personally responsible for any liability. 

I recognize that any form of physical activity is a potentially hazardous one, and that they involve a risk of possible injury or even death. I hereby affirm that I am voluntarily participating in these activities with the knowledge of the risk involved. I agree to expressly assume and accept any and all risks of injury and/or death. 
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I hereby affirm myself to be physically sound and suffering from no condition, aliment, impairment, disease, or other illness that would prevent my participation in physical activities, I declare that I have or will disclose any and all medical history to Whitney R. Simpson and/or affiliates relevant to my participation and have permission from my physician to practice yoga.

    Completing this form serves as your electronic signature.

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  • Home
  • About
    • About Whitney
    • Contact Us
    • FAQ
    • Giving Back
  • Community
  • Offerings
    • Spiritual Direction >
      • Directee Information
    • Contemplative Retreats
    • Yoga & Meditation
    • Courses
  • Podcast
  • Book
  • Blog