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Flourish Yoga
Agreement of Release and Waiver of Liability
First Name
Email Address
Last Name
Date of Birth
It is my responsibility to consult with a physcian and I will inform the yoga instructor of any limitations before participating in a class. I understand that I am fully responsible for any medical issues that may arise. I waive and release Flourish Yoga, Health Golf and Yacht Club, its owners, and instructors from any claims related to my participation in classes offer
No
Yes
I have not exhibited COVID symptoms or have been in contact with anyone in the last 14 days who has been diagnosed with COVID-19 or w/ similar symptoms. I acknowledge the contagious nature of COVID-19 and assume the risk that I may be exposed/infected when attending class and release Heath Golf & Yacht Club, Flourish Yoga, and instructors from any claims resulting in a COVID exposure.
No
Yes
Emergency Contact Name & Phone #:
My initials serve as an agreement to release and waive liability to Flourish Yoga and HG&YC.
Today's Date
I declare that the info I’ve provided is accurate & complete
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