Private Yoga WaiverPrivate Lessons WaiverΔ First NameLast NameAddressAddress Line 1CityStateZip CodeEmailPhone/MobilePlease List any Health Concerns, Injuries, Medical Conditions (Current or Past) that may interfere with your yoga practice:Liability Waiver I, (NAMED ABOVE), hereby agree to the following: I am fully aware of the risks and hazards involved in practicing yoga and yoga-related modalities with Rebecca Jo Phillips. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in private yoga classes, offered by Rebecca Jo Phillips. I represent and warrant that I am physically fit and I have no medical condition(s) that would prevent my full participation in private yoga classes offered by Rebecca Jo Phillips and that I have not, within the past 14-days, experienced any symptoms that could be associated with Coronavirus (COVID-19) or, to my knowledge, been close to anyone who was either known or suspected to have had symptoms that could be associated with COVID-19 during the same time period. In consideration for being permitted to participate in private yoga classes provided by Rebecca Jo Phillips, I agree to assume full responsibility and, on behalf of myself and, to the extent permitted law, my spouse, heirs, executors, administrators, assigns, and other persons or entities acting or purporting to act on my behalf, hereby generally and completely release, acquit, and forever discharge and release Rebecca Jo Phillips from any and all liability for any risks, illnesses, injuries or damages, known or unknown, which I might incur as a result of my participation, which shall include, but not be limited to, being exposed to, or contracting COVID-19. In further consideration thereof, I knowingly, voluntarily and expressly waive any claim I may have against the Rebecca Jo Phillips for any illnesses, injury or damages that I may sustain as a result of my participation. I will not engage in any inappropriate conduct or conduct which is in violation of this Agreement of Release and Waiver which could result in injury or illness to myself or others. I agree that this Agreement of Release and Waiver shall be governed by the laws of New York City and if any conflict arises between me and Rebecca Jo Phillips, I will attempt to resolve the conflict in good faith through mediation before submitting my dispute to binding arbitration. I have read the above release and waiver of liability and fully understand its contents and voluntarily agree to all of the terms and conditions:Cancellation Policy I understand that all cancellations for private sessions must be made at least 24 hours in advance. The full amount for the session will be charged if I do not cancel in time. All sales are final and valid for 6 months. Signature Please Sign HereToday's DateSubmit Form