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Embodied Arts & Wellness

Release and Waiver of Liability 2023

 

I am choosing to participate in Dancing Home, Yoga or movement classes and/or workshops offered through Lucia Rich Khosrowpour DBA Embodied Arts & Wellness (heretofore known as EAAW.)

 

I understand that Dancing Home, yoga or movement classes require physical exertion and that I must have adequate physical and mental health to participate in Dancing Home, yoga or movement classes/workshops. I represent and warrant that I am physically fit enough to participate and I have no medical condition or disability that would prevent or limit my full participation in this class. My signature below verifies that a licensed medical doctor has cleared my physical condition for participation in this type of class.

 

I acknowledge that my enrollment and subsequent participation in this class is purely voluntary and is in no way mandated.

 

I acknowledge that participation in Dancing Home, yoga or movement classes/workshops exposes me to a possible risk of personal injury.  I understand that I may experience muscle, back, neck or other injuries as a result of my participation in classes/workshops through Lucia Rich Khosrowpour/EAAW. I further acknowledge that these classes can cause and/or aggravate an already existing physical injury or medical condition. 

 

I understand my own physical limitations and am sufficiently self-aware enough to stop or modify my participation in any activity before I become injured or aggravate a pre-existing injury.  

 

I am fully aware of the risk, injuries or damages, known or unknown, that I might incur as a result of participating in Dancing Home, Yoga or movement classes/workshops and hereby release Lucia Rich Khosrowpour/EAAW and its affiliates, officers, directors, shareholders, members and employees from any and all liability, negligence, injury, damage or other claims arising from or in any way connected with my participation in Dancing Home, Yoga or movement classes. 

My signature further acknowledges that I shall not now or at any time in the future bring any legal action against Lucia Rich Khosrowpour/EAAW and its affiliates, officers, directors, shareholders, members and employees and that this waiver is binding on me, my heirs, my spouse, my children (including any unborn children), my legal representatives, my successors and my assigns. 

 

If I am pregnant, become pregnant or am post-natal, my signature below verifies that I am participating in Dancing Home, yoga or movement classes/workshops with my doctor or midwife’s full approval. 

 

My signature is binding to this liability waiver from this day forth. 

 

Checking the box on the registration form serves as my signature for this form. 

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