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About
Teachers
Boardmembers
Warriors
YTT
Offerings
Practice
Partners
FAQ
Contact
Gift-based YOGA for ALL
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LIABILITY WAIVER
Participant Name
*
First Name
Last Name
Email
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Phone
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Is the participant 18 years old (or older)?
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YES
NO
Parent or Guardian Name
If the participant is a minor (under 18 years old), please provide the parent or guardian name that is accepting this waiver for the participant
First Name
Last Name
Liability Waiver
*
TERMS & CONDITIONS RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNIFICATION THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS; READ CAREFULLY BEFORE SIGNING. In consideration of the permission to participate in yoga, fitness and/or exercise (collectively, the Activity”) with Cultivate Yoga 501(c)(3) and Cultivate Wellness LCC dba Cultivate Yoga Space (collectively referred to hereinafter as “Cultivate Yoga”), I agree to the terms and conditions contained in this Agreement. In this Agreement, “I,” “me,” and “my” refers to the undersigned and the minor children of the undersigned participating in the Activity, if any. I understand there is inherent risk associated with any exercise program including my voluntary participation in the Activity that may result in injury. I understand and am aware that the Activity is potentially hazardous, and I may be exposed to hazards, including injuries from my lack of fitness or conditioning and/or the negligence of others. I acknowledge that I have had a physical examination and/or have been given permission from my physician to participate in the Activity or that I have decided to participate in the Activity voluntarily without the approval of my physician and hereby assume all responsibility for my participation in the Activity. CORONAVIRUS / COVID-19 WARNING, DISCLAIMER, AND CUSTOMER WARRANT I acknowledge that Coronavirus, COVID-19 is an extremely contagious virus that spreads easily through person-to-person contact. I acknowledge that Federal and state authorities recommend social distancing as a mean to prevent the spread of the virus. I acknowledge that COVID-19 can lead to severe illness, personal injury, permanent disability, and death. I acknowledge that participating in the Activity or accessing Cultivate Yoga’s facilities could increase the risk of contracting COVID-19. I acknowledge that Cultivate Yoga makes no representations or warranties that COVID-19 infection will not occur through participation in the Activity or accessing Cultivate Yoga’s facilities. I hereby agree, represent, and warrant that I shall not participate in any Activity, visit or utilize the facilities, services, and programs of Cultivate Yoga (other than any exclusively online services and programs) within 14 days after (i) returning from highly impacted areas subject to a CDC Level 3 Travel Health Notice, (ii) exposure to any person returning from areas subject to a CDC Level 3 Travel Health Notice, or (iii) exposure to any person who has a suspected or confirmed case of COVID-19. The CDC Travel Health Network is continuously updating this list and I agree that I am aware of this list and the countries listed. I agree to check the CDC Travel Health Notices list prior to participating in an Activity, utilizing the facilities, services, and/or programs of Cultivate Yoga, on a daily basis if necessary. I hereby agree, represent, and warrant that I shall not participate in any Activity, visit or utilize the facilities, services, and/or programs of Cultivate Yoga if I (i) experience symptoms of COVID-19, including, without limitation, fever, cough or shortness of breath, or (ii) have a suspected or diagnosed/confirmed case of COVID-19. I agree to notify Cultivate Yoga immediately if I believe that any of the foregoing participation, visitation or utilization restrictions are applicable to me. I acknowledge and assume both the known and potential risks and dangers of participating in the Activity, utilizing the facilities, services, and programs of Cultivate Yoga and acknowledge that my use thereof may, despite Cultivate Yoga’s reasonable efforts to mitigate such dangers, result in exposure to the coronavirus and contracting COVID-19, which could result in quarantine requirements, serious illness, disability, and/or death. ‘In Good Health’ Verification. When attending in-studio classes/session, I will only attend and enter Cultivate Yoga facilities, when I am in good health and have not been in contact with anyone experiencing symptoms of COVID-19 as detailed by the CDC guidelines. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html Assumption of Risks. I hereby freely assume all the above mentioned risks and hazards described above (including any and all risks associated with the coronavirus and COVID-19) and any harm, injury or loss (including any and all harm, injury or loss associated with the coronavirus and COVID-19) that may occur to me or my property as a result of my participation in the Activity, including any injury or loss caused by the negligence of Cultivate Yoga, its owners, board members, employees, officers, staff, teachers, instructors, independent contractors, or other Activity participants. I also understand that any equipment I use from Cultivate Yoga is at my own risk and that any such equipment is provided without any warranty about its condition or suitability. Release of Liability. I hereby waive, discharge and release Cultivate Yoga together with its owners, board members, employees, officers, staff, teachers, instructors, and independent contractors (collectively, the “Released Parties”) from all liabilities, causes of action, claims, and demands that arise in any way from any injury, death, loss or harm (including injury, death, loss or harm from the coronavirus and COVID-19) that occur to me or to any other person or to any property during the Activity or in any way related to the Activity. This release includes claims for the negligence of the Released Parties or other Activity participants and claims for strict liability. Indemnification. I hereby promise to indemnify, hold harmless and defend the Released Parties against any and all liabilities, causes of action, claims, and demands described in the “Release of Liability” Section above including claims for the Released Parties’ negligence. I also promise to indemnify, hold harmless and defend the Released Parties against any and all claims for my own negligence, and any other claim arising from my conduct during the Activity. In accordance with these promises, I will reimburse the Released Parties for any damages, reasonable settlements, and defense costs, including attorney’s fees, that they incur because of any such claims made against them. I agree that this Agreement will be binding upon me, my heirs, agents, personal representatives, executors, administrators, and assigns. I agree that the purpose of this agreement is that it shall be an enforceable release of liability and indemnity as broad and inclusive as is permitted by Ohio law. I agree that if any portion or provision of this agreement is found to be invalid or unenforceable, then the remainder will continue in full force and effect. I also agree that any invalid provision will be modified or partially enforced to the maximum extent permitted by law to carry out the purpose of the agreement. I have read this Agreement and I fully understand its term and conditions.
I accept this liability waiver
Thank you!