Agreement of Release and Waiver of Liability

Consent to Participate in Yoga Instruction, Meditation, Dance, Trainings (YTT), and Workshops Conducted by MOMENTUM Revitalizing Visionary Leaders, Anne-Tyler Harshbarger, E-RYT 500

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I agree to assume full responsibility for all risks of injury and damage from yogic practices taught under the instruction of Anne-Tyler Harshbarger, E- RYT 200. I agree to let the instructor know of any pre-existing medical conditions I may have.

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It is our policy to maintain the confidentiality of participants in classes and names never accompany photographs or audio that we use for advertising purposes. Please sign below if you give MOMENTUM, Anne-Tyler Harshbarger, permission.

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I, (please print) hereby agree to the following:

That I am participating in the yoga or movement classes, health programs, trainings (YTT), workshops, retreats or services offered by MOMENTUM, Anne-Tyler Harshbarger, E-RYT 500 during which I will receive information and instruction or other services offered pertaining to yoga, meditation, dance, energy healing, sound healing, health practices, and other applicable life skills. I recognize that yoga/dance, requires physical exertion which may be strenuous and cause physical injury, and I am fully aware of the risks and hazards involved.
I understand that it is my responsibility to consult with a physician prior to and regarding my participation in yoga/dance classes, health programs, workshops, or services.
In consideration of being permitted to participate in or receiving services, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in classes or services.
In further consideration of being permitted to participate in yoga/dance classes, I knowingly, voluntarily and expressly waive any claim I may have against MOMENTUM, Anne-Tyler Harshbarger, E-RYT 500 for injury or damages that I may sustain as a result of participating in the classes or from receiving any services.
I, and my heirs or legal representatives, forever release, waive, discharge and covenant not to sue MOMENTUM, Anne-Tyler Harshbarger, E-RYT 500 for any damage or loss caused by their negligence or other acts, including accidental death.

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions listed above.

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