Filly Lane Yoga Waiver Release Form

I understand that yoga includes physical movements as well as an opportunity for relaxation,

stress reduction and relief of muscular tension. Participation in yoga class includes, but is not

limited to, participation in meditation techniques, yogic breathing techniques, and performing

various yoga postures. Yoga postures, or asanas, are designed to exercise every part of the

body-stretching and toning the muscles and joints, the spine and the entire skeletal system.

They also work on the internal organs, glands and nerves. Yoga incorporates sustained

stretching to strengthen muscles and increase flexibility. Yoga is an individual experience.

As is the case with any physical activity, the risk of injury, even serious or disabling, is always

present and cannot be entirely eliminated. My signature acknowledges I understand that in yoga

class I will progress at my own pace. If I experience any pain or discomfort, I will listen to my

body, adjust the posture and ask for support from the yoga teacher (the “Teacher”). I will

continue to breathe smoothly. If at any point I feel overexertion or fatigue, I will respect my

body’s limitations and I will rest before continuing yoga practice.

Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not

recommended and is not safe under certain medical conditions. I affirm that I alone am

responsible to decide whether to practice yoga.

By signing my name below, I acknowledge that participation in yoga classes exposes me to a

possible risk of personal injury. I am fully aware of this risk. I hereby consent to receive medical

treatment that may be deemed advisable in the event of injury, accident and/or illness during

any yoga class.

I hereby take action for myself, my executors, administrators, heirs, next of kin, successors and

assigns as follows: I (a) irrevocably WAIVE, RELEASE AND DISCHARGE FROM ANY AND

ALL LIABILITY for my death, disability, personal injury, property damage, property theft or

actions of any kind which hereafter may occur to me, including my traveling to and from yoga

classes, Teacher and yoga class location, who is hosting these classes and where sessions are

being held, and each of their directors, officers, employees, volunteers, representatives and

agents; and (b) INDEMNIFY, HOLD HARMLESS AND AGREE NOT TO SUE the entities or

persons mentioned in this paragraph as to any and all liabilities or claims made as a result of

participation in the yoga classes, whether caused by the negligence of releases or otherwise.

My signature further acknowledges that I shall not now or at any time in the future bring any

legal action against Teacher and/or this location; and that this waiver is binding on me, my heirs,

my spouse, my children, my legal representatives, my successors and my assigns. My

signature verifies that I am physically fit to participate in yoga classes and a licensed medical

doctor has verified my physical condition for participation in this type of class.

If I am pregnant or become pregnant or am post­natal, my signature verifies that I am

participating in yoga classes with my doctor’s full approval. I realize that I am participating in

yoga classes at my own risk.

The Filly Lane Yoga Waiver Release Agreement shall be construed broadly to provide a release

and waiver to the maximum extent permissible under applicable law. I acknowledge that this

Student Waiver Agreement form will be used by the persons or entities being released in the

yoga classes and that it will govern my actions and responsibilities in said classes. I hereby

certify that I have read this document; and, I understand its content. I am aware that this is a

release of liability as well as a contract and I sign it of my own free will. I also understand at the

yoga classes or related activities, I may be photographed. I agree to allow my photo, video or

film likeness to be used for any legitimate purposes by the Teacher.