Participant Enrollment Form
Yoga with Rebecca Wilhelm
Please ﬁll out completely before you participate in yoga class.
By providing email, you agree to be on our mailing list.
I hereby consent as a participant in yoga classes and agree to assume all of the risks involved. I understand that Rebecca Wilhelm does not provide medical insurance relative to accidents, injuries, and/or death as a result of yoga related activities, and that I cannot hold Rebecca Wilhelm personally responsible for any liability.
I recognize that any form of physical activity is a potentially hazardous one, and that they involve a risk of possible injury or even death. I hereby affirm that I am voluntarily participating in these activities with the knowledge of risk involved. I agree to expressly assume and accept any and all risks of injury and/or death.
I hereby affirm myself to be physically sound and suffering from no condition, ailment, impairment, disease, or other illness that would prevent my participation in Yoga with Rebecca Wilhelm. I understand it is my personal responsibility to consult with my doctor regarding my participation.
I agree to the release of my image in the form of photos or videography for the promotional use of Rebecca Wilhelm.