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Willow Tree Wellness Waiver

To register for a class please fill out the following waiver

It is your responsibility to inform the instructor of any restrictions you may have before class

I understand that yoga includes physical activity and, as with all physical activity, there is the risk of injury
of varying types and degrees, which cannot be entirely eliminated. If I experience any pain or discomfort,
I agree that I will discontinue the activity, and ask for support from the instructor.


I assume full responsibility for any and all damages which may be incurred as a result of my participation in the yoga

I understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment, nor is
yoga recommended or safe under certain medical conditions. By signing, I affirm that a licensed
physician has verified the status of my health and physical condition as sufficient to allow me to
participate in the physical activity required by the yoga program..


I agree that I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant, or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate.

I also affirm that I alone am responsible to decide whether to practice yoga and my participation is at my
own risk.


I agree to irrevocably release and waive any claims that I have now or may have hereafter
against Willow Tree Wellness of Virginia, and its instructors, principals, agents, contractors, employees,
and volunteers.

I have read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am
signing this agreement voluntarily and recognize that my signature serves as complete and unconditional
release of all liability to the greatest extent allowed by law in the Commonwealth of Virginia.

Acceptance of this waiver constitutes my signature if this is being viewed via digital format.

Thanks for submitting!