Health Declaration &
Waiver

Please fill out the following form
in order to participate in our activity.

Have you been hospitalized in the last 12 months?
Are you suffering from a medical condition, illness, or injury?

Medical Waiver​

1. I am participating in yoga classes, health programs, workshops and/or other wellness, body work, therapy, exercise and healing arts activities (collectively, the “Activities”) offered by Christine Clardy and/or Bent Twig Studio, LLC. The Activities may be offered in the physical location of Bent Twig Studio, other physical locations including outdoors, or offered online by videos, television, podcasts, apps or other digital media or platforms. All of such offerings, either physical or online, shall be considered “Activities.”

2. I recognize that I must be in adequate physical and mental health to participate in the Activities. I understand that the Activities may require intense physical exertion, and I represent and warrant that I am physically fit enough to participate, and I have no medical condition which would prevent my full participation in the Activities. I recognize that the Activities may cause or aggravate a physical injury or medical condition. I understand that it is my responsibility to consult with a physician before my participation in the Activities. If I have done so, I have taken the physician’s advice.

3. I understand that this class includes physical movements as well as an opportunity for relaxation.  As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the instructor. I assume full responsibility for any and all damages, which may incur through participation.

4. I affirm that a physician has verified my good health and physical condition to participate in such a fitness program. In addition, I will make the instructor aware of any medical conditions or physical limitations by email well in time before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, I verify that I have my physician's approval to participate. I also affirm that I alone am responsible to decide whether to participate, and I do so at my own risk.

5. I understand that Christine Clardy reserves the right to refuse my participation in any Activity on medical, fitness or any other grounds.

6. In consideration of being permitted to participate in the Activities, 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 the Activities. 

This class is not a substitute for medical attention, examination, diagnosis or treatment. It is not recommended 

under certain medical conditions.

Please note that video, photo or audio recording of

online classes is not permitted. 

 

By initialing this document and clicking the confirmation boxes below, I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Christine Clardy MA, RYT200 or Bent Twig Studio, LLC.  I also have read and fully understand and agree to the above terms of this Liability Waiver Agreement.  And I am participating voluntarily, recognizing that this document serves as complete and unconditional release of all liability to the greatest extent allowed by law.

Thanks for submitting!