Student Waiver Form - Elevate Yoga
ADVERTISEMENT
1Student Waiver Form
I ___________________________________________________ am a participant in Ottawa, Ontario in the Yoga program
(hereinafter referred to as the ‘program’) of Elevate Yoga on 298 Elgin Street.
I declare that I understand the nature of the program, and I also understand that the nature of this document is to waive
my rights against Elevate Yoga and its instructors, in the event that something should happen to me while participating
in the program, and that by signing this document I release Elevate Yoga and the instructors from any responsibility and
liability.
I understand that Elevate Yoga assumes no responsibility for any loss or damage to any personal property on the
premises at which the program is conducted. I waive any possibility of personal damage which may be blamed on such a
program in the future and accept responsibility for requesting the Yoga program and assistance provided by Elevate
Yoga.
I acknowledge that I have been advised in this format to see my doctor to discuss any concerns I may have about
participating in the yoga program with Elevate Yoga on 298 Elgin Street.
I further acknowledge by my signature below that I have read this waiver carefully and understand its terms.
Student Information:
Emergency Contact
Last Name:
Name:
First Name:
Relationship:
Date of Birth:
Phone #:
Receive a complimentary Birthday Class on your birthday!
□
□
□
Mobile
Home
Office
Phone #:
ADMIN ONLY
□
□
□
Mobile
Home
Office
Phone #:
Paid: Yes | No
Method: Visa| MC | AX | Debit | Cash
□
□
□
Mobile
Home
Office
Discount: Student 20% | Senior 10%
Email:
Purchase(s): ________________________________
Used for account login and newsletter goodies!
How did you hear about us?
□
□
□
□
□
□
□
□
Website
Google
Facebook
Twitter
Instagram
Sign
Friend
Other:
Signature: Date: Witness:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal