Yoga Roots Studio LLC Manzanita Liability and Release Waiver

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Name:

Address:

Phone:  home or cell:

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Liability Release:  I agree to hold Charlene Gernert/Katie Crosman /Yoga Roots Studio LLC of Manzanita Oregon/ Howel’s Plaza and/or their employees, agents representatives, instructors, and volunteers harmless from any and all claims, dues, or demands arising from participating in their programs, classes, workshops, festivals, and trainings.  I, for myself, my heirs executors, administrators and assigns, forever waive, release and discharge any and all right, demands, claims, and causes of suit or action, known, or unknown, that I may have against any and all participating employees, sponsors, contributors, supporters, volunteers, and directors, officers agencies of such parties, for any and all injuries and damages is any manner arising or resulting from my participation or my child’s participation in Charlene Gernert or Katie Crosman’s /Yoga Roots Studio LLC of Manzanita Oregon/ Howel’s Plaza and/or their employees, agents representatives, instructors, and volunteers yoga programs, workshops, or classes.  I attest and verify that I have full knowledge of the risk in this activity, including but not limited to falls and/or contact with other participants: that I assume those risks, and that myself and/or my child is physically fit and sufficiently trained to participate in this activity. I have read the information provided for the activity and certify my compliance by my signature.  I certify that information provided on this form is true and complete.

 Participants Signature

Date