Name *

First Name

Last Name

I hereby agree that Yoga in the Vines, it’s Directors or nominated agent shall not be liable, for any loss, damage or personal injury suffered by me, whether directly or indirectly arising out of any act or omission by Yoga in the Vines, its Directors or its agent. I am aware of the possible health and safety risks associated with participating in physical exercise and consent to any reasonable exercise, which may from time to time be strenuous. I have made Yoga in the Vines, its Directors or it’s agent aware of any relevant medical or health problems that I currently or likely to suffer from and have obtained a clearance from a registered medical practitioner to participate in physical exercise. I acknowledge sole responsibility for any personal equipment. I consent to receive medical treatment, which may be deemed necessary in the event of injury, accident or illness. (If you are under 18 years of age, a signed consent of your legal guardian must be obtained. It is the policy of Yoga in the Vines that, as an essential condition of entry to any class or retreat, participants not be under the influence of alcohol or any substance that may affect their ability or behaviour towards other class members, staff or visitors. Yoga in the Vines reserves the right for its management and staff, in their absolute discretion, to refuse entry and or participation in any class to any person acting contrary to this policy. I acknowledge reading the above and by ticking and giving consent below, agree to Yoga in the Vines’ Indemnity Waiver and furthermore by signing below, agree to comply as a condition of entry to Yoga in the Vines. *

I consent to the above