YOGATHON
P ARTICIPANT
OFFLINE
R EGISTRATION
F ORM
Yogathon
C hallenge,
$ 20,
A pril
1 4th-‐May
2 5th
2 013
Name:
_ __________________________________________________________
PAYMENT
O PTIONS:
Email:
__________________________________________________________
____Cash,
$ _________________
Address:
_________________________________________________________
____Check,
$ ________________
City:
_____________________________
S tate:
_ ____
Z ip:
________________
____Credit,
$ _______________
Phone:
__________________________________________________________
Credit
C ard
N umber:
Your
Y oga
C lass
C hallenge
G oal
( e.g.
1 0,
2 0,
5 0
c lasses):
___________________
____________________________
_ _
_ _
_ _
_ _
T-‐shirt
s ize*:
Small
Medium
Large
XL
( *t-‐shirts
a nd
p rizes
Exp.
d ate:
_ ________________
are
a warded
b ased
o n
f undraising
t arget
l evels
a nd
w ill
b e
g iven
o ut
a t
t he
e nd
of
t he
Y ogathon
e vent)
Security
C ode:
_ ____________
LIVING
Y OGA
Y OGATHON
E VENT
T ERMS
&
C ONDITIONS
O F
P ARTICIPATION
I
c onfirm
a nd
a gree
t o
t he
f ollowing
t erms
a nd
c onditions.
•
I
a m
o ver
1 8
y ears
o f
a ge.
•
I
a cknowledge
a nd
a gree
t hat
p articipation
i n
a ny
Y oga
E xercises
c ould
c onstitute
a
r isk
o f
s erious
i njury
t o
m yself.
I
w illingly
a nd
k nowingly
a ccept
t his
r isk
•
and
g ive
a ssurance
t hat
I
a m
p hysically
f it
a nd
a ble
t o
p erform
Y oga
E xercises.
I
u nderstand
a nd
a gree
t hat
L iving
Y oga,
t heir
d irectors,
e mployees,
s taff,
v olunteers
a nd
s ponsors
a re
n ot
l iable
f or,
n or
e xpected
t o
p rovide
a ny
a dvice,
•
training
o r
m edical
a ssistance.
I
a gree
t hat
t he
c harity
I
h ave
e lected
t o
s upport
m ay
p rovide
t he
o rganizers
w ith
d etails
o f
t he
a mount
o f
s ponsorship
I
h ave
r aised
a nd
t his
f igure
m ay
b e
•
publicized
o n
t he
L iving
Y oga
a nd
Y ogathon
w ebsite.
I
a gree
t hat
t he
o rganizers
m ay
h old
m y
c ontact
d etails
o n
t heir
r ecords
t o
i nform
m e
o f
s ubsequent
c harity
e vents
b eing
h eld
a nd
t hat
t hese
d etails
w ill
•
not
b e
p assed
o n
t o
a ny
o ther
t hird
p arty,
o rganization,
c ompany
o r
i ndividual.
I
g ive
p ermission
f or
m y
p hotograph
o r
v ideo
i mage
t o
b e
u sed
f or
m edia
p urposes
i n
t his
a nd
a ny
f uture
e vents.
I
w aive
a ny
c laim
a nd
r ight
t o
i nspect
t he
•
photographs
a nd
a ny
a dvertising
o r
p romotional
c opy
t hat
m ay
b e
u sed
i n
c onjunction
w ith
t he
e vent.
LIVING
Y OGA
Y OGATHON
E VENT
W AIVER,
R ELEASE
a nd
I NDEMNIFICATION
F ORM
For
m yself,
m y
e xecutors,
a dministrators,
h eirs,
n ext
o f
k in,
s uccessors
a nd
a ssigns.
I
H EREBY:
a.
Waive
a nd
r elease
a ny
a nd
a ll
c laims
t hat
I
m ay
h ave
a gainst
L iving
Y oga,
t heir
d irectors,
e mployees,
s taff,
v olunteers,
a gents
a nd
a ny
o ne
o r
m ore
o f
t hem
or
t heir
e xecutors,
a dministrators,
h eirs,
n ext
o f
k in,
s uccessors
a nd
a ssigns
( "the
r eleasees")
i ncluding
a ny
a nd
a ll
c laims
f or
d amage
c aused
b y
t he
negligence
o f
a ny
o f
t hem,
a rising
o ut
o f
m y
p articipation
i n
t he
e vent
a nd
i ts
r elated
a ctivities,
t ogether
w ith
a ny
c osts
i ncluding
l awyers'
f ees
t hat
m ay
b e
incurred
a s
a
r esult
o f
a ny
s uch
c laim
w hether
v alid
o r
n ot,
a nd
b.
Indemnify
a nd
h old
h armless
t he
r eleasees
a nd
e ach
o f
t hem
a gainst
a ny
s uch
c laim
t hat
I
o r
m y
g uests
o r
a ny
o ne
o r
m ore
o f
m y
o r
t heir
e xecutors,
administrators,
h eirs,
n ext
o f
k in,
s uccessors
a nd
a ssigns
m ay
h ave
o r
a ssert
a nd
a gainst
a ny
c osts
i ncluding
l awyers'
f ees
w ith
r espect
t hereto.
c.
I
h ereby
a cknowledge
t hat
p articipation
i n
t he
L iving
Y oga
Y ogathon
e vent
c arries
w ith
i t
p otential
h azards.
I
t herefore
r elease
L iving
Y oga,
t heir
d irectors,
employees,
s taff,
v olunteers
a nd
s ponsors
o f
a ny
l iability
r esulting
f rom
i njury
o r
d eath
d uring
t he
e vent
a nd
i ts
r elated
a ctivities.
S ignature
D ate