Yoga for Life
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Yoga for Life
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Advanced Workshop Application Saturday April 16, 2005 1:00 PM to 4:00 PM at the Newtown Athletic Club Yoga Room
Limited to 20 Participants
Advance Registration $25 $35 at the Door if space is available
Name __________________________________ Date of Birth: ________________ Address ____________________________________________________________ Home Phone: ____________________ Bus. Phone: ________________________ Email: _______________________________ Fax: __________________________ List any Health or Physical Problems:____________________________________ ___________________________________________________________________ Number of years practicing Yoga: _______________________________________ How many yoga classes do you attend weekly:_____________________________ What styles of Yoga do you practice: _____________________________________ Where do you practice:_________________________________________________
I hereby Irrevocably release and discharge Yoga for Life and all of its representatives, agents and employees, from and against, all legal liabilities, losses claims, claims for relief, causes of action, damages, demands, attorney’s fees and expenses, as to all injuries, death and damages, to person or property in any way resulting from, or arising out of my attendance at or participation in any instruction, workshop, or exhibition, and whether arising while engaged in or departing from them, from any cause whatsoever, including, but not limited to, the failure to make inspections, or, the negligence of any person, and including all matters arising in the future after the date hereof it being my intention, contemplation, understanding and agreement that there shall be no legal liability whatsoever now or in the future to Yoga for Life, nor to any of its representatives, agents or employees. I hereby assume all risks for all injuries, death and damages, to person or property, while I attend, participate or assist in any event, exhibition, instruction, activity or workshop, or any and all other matters relating thereto, in the future. I hereby acknowledge that I fully understand all risks, hazards and damages to myself and to my property while attending, participating or assisting in any event, exhibition, instruction, workshop, or activity, or any other related matters, and hereby voluntarily assume any and all of the above described risks, it being my intention, contemplation, understanding and agreement that there shall be no legal liability whatsoever now or in the future to Yoga for Life, nor to any of its representatives, agents or employees. I have voluntarily entered into this document, with full knowledge, and with the intention and contemplation, that by so doing, I am legally binding and barring myself, my estate, my heirs, my assigns, my trustees, my personal representatives, and any and all other persons who might claims for and on my behalf, from having any legal rights whatsoever to bring any action or recover any damages whatsoever from any of the persons hereinbefore set forth . Please return this application with your check made out to Robert Connell
Signature: ____________________________________ Date: ____________________
Send to: Robert Connell 12 Terry Drive, Suite 201, Newtown, PA 18940 Email: yogaguy@voicenet.com Phone: 215-497-7050
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Copyright © 2006 Yoga for Life
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