New Student Form
The Yoga Seed Collective is a 501(c)(3) Non-Profit Organization. This information helps us learn about the populations we are serving and may also be used for grant writing purposes. Please help us by completing all sections you feel comfortable with, and by printing clearly. Thank you for your support!
FIRST NAME: LAST NAME: EMAIL:
CITY: ZIP: PHONE:
ESTIMATED INCOME per month (optional): $
Have you practiced yoga before? Yes No
Who referred you to The Yoga Seed Collective?
Upon signing below, I do hereby release, forever discharge and agree to hold harmless The Yoga Seed Collective and Yoga Seed Teachers, Assistants, and Volunteer 200-Hour Certified Instructors teaching SEVA and the directors thereof from any and all liability claims or demands for personal injury, sickness or death, as well as property damages and expenses, of any nature whatsoever which may be incurred by the undersigned that occur while said is participating in the above described activity.
Furthermore, I hereby assume all risk of personal injury, sickness, death, damage and expense as a result of participation in recreation activities involved therein.
The undersigned further hereby agrees to hold harmless and indemnify said organization, its directors, employees and agents, for any liability sustained by said participant as the result of negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto.
I have read the above and understand the rules and intent of this liability release form.
Signature of Student/Parent/Guardian