Acknowlegement Of Risks And Hazards Waiver Of Rights (Page 2 of 2) in pdf

latent, or obvious defects on any structural supports or in the equipment, including fabric or

hardware used. ( _______ ) INITIAL

4. I have been advised and recognized that my aerial yoga activities of any kind are not covered

by any personal accident or general liability insurance policies issued to the RELEASED

PARTIES. ( _______ ) INITIAL

5. I understand that because of the unavoidable and unpredictable dangers involved in the

participation in aerial yoga or aerial silks activities of any kind the RELEASED PARTIES make

no warranty of any kind, expressed or implied, concerning any training, equipment, or facilities

provided by the RELEASED PARTIES. Furthermore I recognize that aerial yoga and aerial silks

activities of any kind are a dangerous sport and associated equipment such does not always work

as they are expected to. ( _______ ) INITIAL

6. I understand that because of the nature of aerial silks or aerial yoga activities of any kind, it is

impossible for any person, including the RELEASED PARTIES, to determine with any degree of

certainty that I have been trained properly in the sport. I hereby warrant to the RELEASED

PARTIES, that based upon my own evaluation I believe that I have been adequately trained and

am experienced to safely perform aerial yoga and aerial silks activity of any kind and cope with

the high speed conditions and stress associated with these activities. I further declare that I am not

under treatment for any of the following: Cardiac or pulmonary condition or disease; High or low

blood pressure; Fainting spells or convulsions; Hearing loss or impairment; Nervous disorder;

Diabetes; Kidney or related diseases; Shortness of breath; or Psychiatric disorders. I further

certify and declare that I am not on any recognized medication and have not taken nor will in the

future take alcoholic beverages or drugs within the preceding 12 hours of any aerial silks yoga or

aerial yoga activities of any kind that I may perform now or in the future at Aerial Yoga Houston.

( _______ ) INITIAL

I REAFFIRM MY ASSUMPTION

7. Based upon my independent evaluation of the risks,

OF THE EXTREME RISK AND DANGER SET OUT IN PARAGRAPH 3 ABOVE.

( _______ ) INITIAL

8. I certify that considering my lifestyle and the manner in which I am supporting my dependents,

I have made adequate provision for my spouse, children, or heirs and all other persons dependent

upon me so that in the event of my injury, disability or death they will not suffer a financial loss.

( _______ ) INITIAL

9. I further agree that in the event I have any claim whatsoever against any of the RELEASED

PARTIES arising out of my participation in aerial yoga and/or aerial silks activities of any kind

including an action for personal injury, that it shall be a condition precedent to filing of a lawsuit

against any of the RELEASED PARTIES that the matter first be arbitrated at my expense by an

arbitration board and that the decision and finding of that board shall be final and binding upon

all persons. ( _______ ) INITIAL

10. I agree that venue and jurisdiction for any legal action arising out of any matter which is the

subject of this document shall be determined by the RELEASED PARTIES and that if the Court

should decide that any clause in this contract is illegal or unenforceable, such determination shall

not affect the validity or enforceability of the remaining provisions. ( _______ ) INITIAL

I HAVE CAREFULLY READ THIS AGREEMENT AND RELEASE OF

LIABILITY, I FULLY UNDERSTAND ITS CONTENTS AND SIGN BELOW OF

MY OWN FREE WILL.

Student :

Name___________________________________________________________ (print)

Signature ________________________________________________________

Date ____________________________________________________________

Acknowlegement Of Risks And Hazards Waiver Of Rights Page 2

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