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Yoga Release & Waiver of Liability
Yoga Waiver
Yoga Release & Waiver of Liability
Name
*
Name
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First Name
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Last Name
Mobile
*
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Address
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Address
Address
Address
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Brazil
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Christmas Island
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Croatia
Cuba
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French Polynesia
French Southern Territories
Gabon
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Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
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Holy See
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Iraq
Ireland
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New Caledonia
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Niger
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Niue
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North Korea
Northern Mariana Islands
Norway
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Pakistan
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Panama
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Pitcairn
Poland
Portugal
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Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
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Tuvalu
Uganda
Ukraine
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Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Date of Birth
*
Age
Have you any medical conditions?
*
No
Yes
Please give the details of medical conditions below.
*
Parent/Guardian Information
Parent/Guardian Name
*
Parent/Guardian Name
First Name
First Name
Last Name
Last Name
Relationship
*
Father
Mother
Guardian
Sister/Brother
Partner
Parent/Guardian Phone
*
Parent/Guardian Email
*
Parent/Guardian Address
*
Parent/Guardian Address
Parent/Guardian Address
Parent/Guardian Address
Town/City
Town/City
County
County
Post Code
Post Code
Country
United Kingdom
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
YOGA RELEASE & WAIVER OF LIABILITY Provider: Demi Ellis (classes booked via demiellis.com) Please read carefully before signing. I understand that yoga involves physical movement, breathwork, and relaxation techniques. As with any physical activity, the risk of injury (including but not limited to muscle strain, sprain, or more serious injury) is always present and cannot be entirely eliminated. HEALTH & PARTICIPATION I am responsible for my own health and well-being during class. I confirm I'm responsible to make sure i am physically fit to participate in any classes booked and have consulted a healthcare professional if appropriate. I will listen to my body, modify or stop any activity that causes pain or discomfort, and request support when needed. I will inform the instructor before class of any injuries, limitations, or pregnancy. ADJUSTMENTS & CUES I understand that verbal cues and optional hands-on adjustments may be offered to support alignment and safety. I may decline adjustments at any time and will communicate my preference to the instructor. ASSUMPTION OF RISK & RELEASE In consideration of being permitted to participate, I knowingly and voluntarily assume all risks associated with yoga classes, workshops, private sessions, events, virtual/online classes and all related activities with Demi Ellis. To the fullest extent permitted by law, I release, waive, and discharge Demi Ellis, any assistants, and the venue from all claims, demands, causes of action, damages, or liabilities arising out of or related to my participation, whether arising from negligence or otherwise. MEDIA CONSENT I understand that classes or events may occasionally be photographed or recorded for promotional purposes. I consent to the use of my image and likeness unless I notify the instructor in advance by ticking the check box on the event booking form. BEHAVIOUR & PARTICIPATION I agree to follow all class guidelines and reasonable instructions for safety. I understand that if I decline to complete this waiver when requested, or if I do not follow safety guidance, my participation may be refused and any related booking through demiellis.com may be cancelled in accordance with the stated terms. DATA & RECORDS I consent to the collection and secure storage of this waiver and my contact details for record-keeping and safety/insurance purposes. Records may be retained for a reasonable period (e.g., up to 6 years) and handled in line with applicable data protection laws. For questions about your data, please contact the site owner via demiellis.com. MINORS If the participant is under 18, a parent or legal guardians details will be required before being able to submit the form. ACKNOWLEDGEMENT By checking the box below, I confirm that I have read and fully understand this Yoga Release & Waiver of Liability, that I am agreeing to it voluntarily, and that I agree to its terms. I understand that by checking the box and submitting this form it is legally binding.
Acknowledgment
Agreement
*
I have read and understand the waiver agreement above and by checking this box, I hereby agree and confirm that I will abide by it.
Date
*
Submit
Start Over
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Yoga Release & Waiver of Liability
Yoga Waiver
Yoga Release & Waiver of Liability
Name
*
Name
First Name
First Name
Last Name
Last Name
Mobile
*
Email
*
Address
*
Address
Address
Address
Town/City
Town/City
County
County
Post Code
Post Code
Country
United Kingdom
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
Date of Birth
*
Age
Have you any medical conditions?
*
No
Yes
Please give the details of medical conditions below.
*
Parent/Guardian Information
Parent/Guardian Name
*
Parent/Guardian Name
First Name
First Name
Last Name
Last Name
Relationship
*
Father
Mother
Guardian
Sister/Brother
Partner
Parent/Guardian Phone
*
Parent/Guardian Email
*
Parent/Guardian Address
*
Parent/Guardian Address
Parent/Guardian Address
Parent/Guardian Address
Town/City
Town/City
County
County
Post Code
Post Code
Country
United Kingdom
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Côte d'Ivoire
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Country
YOGA RELEASE & WAIVER OF LIABILITY Provider: Demi Ellis (classes booked via demiellis.com) Please read carefully before signing. I understand that yoga involves physical movement, breathwork, and relaxation techniques. As with any physical activity, the risk of injury (including but not limited to muscle strain, sprain, or more serious injury) is always present and cannot be entirely eliminated. HEALTH & PARTICIPATION I am responsible for my own health and well-being during class. I confirm I'm responsible to make sure i am physically fit to participate in any classes booked and have consulted a healthcare professional if appropriate. I will listen to my body, modify or stop any activity that causes pain or discomfort, and request support when needed. I will inform the instructor before class of any injuries, limitations, or pregnancy. ADJUSTMENTS & CUES I understand that verbal cues and optional hands-on adjustments may be offered to support alignment and safety. I may decline adjustments at any time and will communicate my preference to the instructor. ASSUMPTION OF RISK & RELEASE In consideration of being permitted to participate, I knowingly and voluntarily assume all risks associated with yoga classes, workshops, private sessions, events, virtual/online classes and all related activities with Demi Ellis. To the fullest extent permitted by law, I release, waive, and discharge Demi Ellis, any assistants, and the venue from all claims, demands, causes of action, damages, or liabilities arising out of or related to my participation, whether arising from negligence or otherwise. MEDIA CONSENT I understand that classes or events may occasionally be photographed or recorded for promotional purposes. I consent to the use of my image and likeness unless I notify the instructor in advance by ticking the check box on the event booking form. BEHAVIOUR & PARTICIPATION I agree to follow all class guidelines and reasonable instructions for safety. I understand that if I decline to complete this waiver when requested, or if I do not follow safety guidance, my participation may be refused and any related booking through demiellis.com may be cancelled in accordance with the stated terms. DATA & RECORDS I consent to the collection and secure storage of this waiver and my contact details for record-keeping and safety/insurance purposes. Records may be retained for a reasonable period (e.g., up to 6 years) and handled in line with applicable data protection laws. For questions about your data, please contact the site owner via demiellis.com. MINORS If the participant is under 18, a parent or legal guardians details will be required before being able to submit the form. ACKNOWLEDGEMENT By checking the box below, I confirm that I have read and fully understand this Yoga Release & Waiver of Liability, that I am agreeing to it voluntarily, and that I agree to its terms. I understand that by checking the box and submitting this form it is legally binding.
Acknowledgment
Agreement
*
I have read and understand the waiver agreement above and by checking this box, I hereby agree and confirm that I will abide by it.
Date
*
Submit
Start Over
If you are human, leave this field blank.