New Student Registration

Selah Yoga

new student registration | liability waiver

First Name

Address & Zip

Email Address

Last Name

Contact Number

Date of Birth

I represent and warrant that I am in good physical health and do not suffer from any medical condition which would limit my participation in any given teaching, instruction, therapy, coaching, etc. offered through Selah Yoga. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any of the yoga classes, programs or workshops.

Yes

I hereby WAIVE and RELEASE Selah Yoga Studio, its owner. teachers, other students or participants, or teachers from any claim, demand, cause of action of any kind resulting from or related to my participation in the programs offered at any facility where instruction occurs.

Yes

In taking part in the yoga products, aroma therapy, coaching, classes, practices, halo therapy, workshops or other activities with Selah Yoga Studio. I understand and acknowledge that I am fully responsible for any and all risks, injuries, or damages, known or unknown, which might occur as a result of my participation in the above mentioned activities.

Yes

Signature

Today's Date

I have read the above release and waiver of liability and fully understand its content. I am legally competent to sign and voluntarily agree to the terms and conditions stated above.

submit once, it does go through `;)