Awaken Sound Health, LLC
WAIVER AND RELEASE OF LIABILITY
In consideration of the risk of injury while participating in yoga based movement programs, classes or workshops (the "Activity"), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge Awaken Sound Health, LLC, located at 32 Grove Street, Chester, New Jersey 07930, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity.
I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK. I UNDERSTAND THE ACTIVITY INCLUDES PHYSICAL MOVEMENT AND THERE IS A RISK OF INJURY, PAIN, SUFFERING, ILLNESS, TEMPORARY OR PERMANENT DISABILITY. I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHER’S NEGLIGENCE. NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN OR UNKNOWN TO ME, OF MY PARTICIPATION IN THE ACTIVITY.
I agree to indemnify and hold harmless Awaken Sound Health, LLC against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Awaken Sound Health, LLC incurs any of these types of expenses, I agree to reimburse Awaken Sound Health, LLC.
I acknowledge that Awaken Sound Health, LLC and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Awaken Sound Health, LLC.
I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Awaken Sound Health, LLC AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Awaken Sound Health, LLC FOR PERSONAL INJURY OR PROPERTY DAMAGE.
To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of Awaken Sound Health, LLC, its agents, affiliates and employees.
In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance.
This Agreement was entered into at arm's-length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength. Both the Participant, ______________________________________________, and Awaken Sound Health, LLC agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purposes for which it is entered into.
In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties. If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.
In the event of an emergency, please contact the following person(s) in the order presented:
Emergency Contact ___________________________________________________________ Contact Relationship __________________________________________________________ Contact Telephone ____________________________________________________________
I, the undersigned participant, affirm that I am of the age of 18 years or older, and that I am freely signing this agreement. I certify that I have read this agreement, that I fully understand its content and that this release cannot be modified orally. I am aware that this is a release of liability and a contract and that I am signing it of my own free will.
Participant's Name: ___________________________________________________________ Participant's Address: _________________________________________________________ Signature: __________________________________________________________________ Date: ______________________________________________________________________
STUDENT’S BIRTHDAY: MO / DAY /YEAR EMAIL:
CITY: STATE: ZIP CODE:
EMERGENCY CONTACT NAME:
Liability Waiver Agreement
Please read carefully.
I_______________________________________________, hereby agree to the following:
1. I am participating in the Yoga and/or meditation classes, programs or workshops offered by Annamaria Palma, DBA Essence Yoga, LLC, (hereafter referred to as Anna Palma) during which I will receive information and instruction about yoga and meditation. I recognize that yoga, and other movement programs require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
2. I understand that yoga includes physical movements, as well as an opportunity for relaxation and stress reduction. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. Also, yoga can stir up emotions, and the possiblity or extent of that possibilty and my reaction to such experiences cannot be pre-determined or eliminated. If I experience any physical or emotional pain or discomfort, I will listen to my body, discontinue the activity and ask for support from the instructor. I will continue to breath smoothly.
3. Yoga is not a substitute for medical attention, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. By signing, I affirm that the appropriate licensed physician or health care professional has verified my good health and physical condition to participate in yoga/meditation/wellness programs offered by Anna Palma. In addition, I will make the instructor aware of medical conditions and associated limitations I have before class. I acknowledge that if any information changes I will notify my instructor, and take full responsibility for non-disclosure. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my appropriate physician’s approval to participate.
I also affirm that I alone am responsible to decide whether to practice yoga and participation is at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Anna Palma.
4. I am not relying on any oral, written or visal representations or statements made by Essence Yoga, LLC, including brochures or promotional materials to induce me to participate in this activity.
5. In consideraton of being permitted to participate in Yoga classes, workshops, or wellness programs, I agree to assume full responsiblity for any risks, injuries or damages known or unknown, which I might incur as a result of my participation. I, my heirs, assigns, or legal representative forever release waive, discharge and covenant to not sue or make any other claims whatsover against Anna Palma or Essence Yoga for any personal injury, property damage/loss or wrongful death whether caused by negligence or otherwise.
6. I have read the above Liabilty Waiver Agreement and fully understand it’s contents. I voluntatily agree to the terms and conditions stated above. I am signing this agreement voluntarily and recognzie that my signature serves as complete and unconditional release of all liabilty to the greatest extent allowed by law in the State of NJ.
SIGNATURE OF PARTICIPANT__________________________DATE__________________