Student Sign Up

Default-image
Yoga OM Alaska
Default-user-thumb
Please note, all fields marked with (*) are required.
Please read the following carefully:
PARTICIPANT AGREEMENT, RELEASE AND ASSUMPTION OF RISK In consideration of the services of Yoga OM Alaska, Yoga OM, Sonia and/or David Auld, City of Wasilla, their kin, agents, owners, officers, volunteers, students, participants, employees, & all other persons or entities acting in any capacity by, through, under or on their behalf (hereinafter collectively referred to as the indemnified parties) I hereby agree to release, indemnify, and discharge the indemnified parties on behalf of myself, my spouse, my children, my parents, my heirs, assigns, personal representative and estate as follows: I acknowledge that my participation in performance and training, individual and group initiatives, problem solving exercises, personal growth and development exercises utilizing yoga, aerial yoga, silks and vertical rope entails known and unanticipated risks that could result in physical or emotional injury or death. I understand that such risks simply cannot be eliminated without jeopardizing the essential qualities of the activity. The risks include, among other things: the hazards of slips and falls; being struck by objects dislodged or dropped from above; the hazards from using safety ropes and equipment; the risks of falling off equipment; the risks of landing improperly on a safety mat; the risks of being entangled in safety lines; my own physical condition, and the physical exertion associated with this activity. Furthermore, the indemnified parties (instructors) have difficult jobs to perform. They seek safety, but they are not infallible and among other things (1) they might misjudge their own ability, (2) they might misjudge the weather or other environmental conditions, (3) they may give incomplete or inaccurate instructions or warnings, and (4) the equipment being used might malfunction. I expressly agree and promise to accept and assume all of the risks existing in this activity. My participation in this activity is purely voluntary, and I elect to participate in spite of the risks I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless the indemnified parties from and against any and all claims, demands, suits, judgments, damages, liability, cost or expense, or causes of action, which are in any way connected with my participation in any activity at the indemnified parties property or my use of any of the indemnified parties’ equipment or facilities, including but not limited to those alleging negligent acts or omissions. I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. Should the indemnified parties or anyone acting on their behalf, be required to incur reasonable attorney's fees and costs to enforce this agreement, I agree to indemnify and hold them harmless for all such fees and costs. Notwithstanding anything to the contrary herein, in the event that I file a lawsuit against the indemnified parties, I agree to do so solely in the state of Alaska, and I further agree that the substantive law of Alaska shall apply in that action without regard to the conflict of law rules of that state. I agree that if any portion of this agreement is found to be void or unenforceable, the remaining document shall remain in full force and effect. By signing this document, I acknowledge that if anyone is hurt, or property is damaged or lost during my participation in this activity, I waive my right to maintain a lawsuit against the indemnified parties on the basis of any claim from which I have released them herein. MEDIA/PHOTO WAIVER: I hereby authorize and give my full consent to Yoga OM Alaska to copyright and/or publish any and all photographs, digital recordings, videotapes and/or film in which I appear may be used for public view. I further agree that Yoga OM Alaska may transfer, use or cause to be used these digital recordings, photographs, videotapes, or films for any exhibitions, public displays, publications, commercials, art and advertising purposes, television programs, and internet without limitations or reservations. I have had sufficient opportunity to read this entire document. I have read and understood it, and I agree to be bound by its terms. I agree that a digitally reproduced/scanned version of this waiver is fully valid and representative of the original, signed executed copy. I certify to the best of my knowledge that I DO NOT have any of the following: Heart disease,glaucoma, high or low blood pressure, epilepsy, fainting spells, recent surgery or severe injury. Any of the previous conditions disqualify students from participating in aerial yoga classes.
And sign in the box below: Clear must be signed