Mindful Movement Waiver Form
Thank you for choosing to join the 4-Week Mindful Movement Series. We look forward to showing you the many benefits that mindfulness and movement modalities have to offer. While the physical activity in this series will be presented with the best of intentions, injuries may result, discomfort may occur or prior conditions may be aggravated. Please take responsibility for your own body. Respect your body and understand that you should practice at your own pace. Practice with awareness and care and do not let any person or situation push you beyond your capabilities. If you are pregnant or have a medical condition, i.e. low blood pressure, heart condition, or previous, current or chronic injuries, please let Elena know prior to commencing the series. We ask that you sign the waiver form as a mutual expression of good faith. AGREEMENT OF RELEASE AND WAIVER OF LIABILITY PLEASE READ CAREFULLY
Name *
Phone *
Emergency Contact *
Emergency Contact
Emergency Contact Number *
Emergency Contact Number