Yoga for Back Pain Liability Waiver & Consent Form

I acknowledge that I have enrolled in a yoga program offered by Kirstie Griffiths Chiropractic & Yoga. I recognize that the these classes may involve strenuous physical activity including, but not limited to muscle strength and endurance training, cardiovascular conditioning and training, and other various fitness activities. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition that would prevent or limit my participation in the training sessions/classes. I have been cleared by a doctor to exercise with any pre-existing injuries or conditions.

I acknowledge and understand that each person has a different capacity for participating in fitness activities and there are inherent risks associated with participating in fitness activities, including all manners of injury, the failure of equipment and the carelessness of other participants. I agree to participate in the program and willingly assume full responsibility, and any risks of injury, for myself in connection with my participation in these sessions.

I, on behalf of myself and my other heirs, next of kin, executors, administrators and assigns, agree to waive all claims that I may have or may have in the future against Kirstie Griffiths Chiropractic and Yoga and their instructors/staff, and release and forever discharge Kirstie Griffiths Chiropractic and Yoga and their instructors/staff from all liability for any personal injury, death, property damage, or other loss and liabilities of whatsoever nature or kind arising out of or in any way connected with my participation in the programs.

Due to the small group nature of the program and limited space, payment must be made for the program in full prior to the start of the program and refunds cannot be offered for class absence or withdrawal from the program.  Payment is due within 24 hours of signing this agreement to reserve your space.  Information and sequencing from the program can be made available upon request in print so that participants may have access to information from classes missed due to extenuating circumstances however receipts cannot be issued for classes missed and therefore cannot be submitted for reimbursement through extended health plans.  In the unlikely event of program interruption due to lockdown, participants will be granted access to the full online 12-week Yoga for Back Pain program.  Program refunds will not be issued and make-up classes are not guaranteed.

COVID-19 Release:

We take COVID-19 seriously and have put protective measures in place to reduce the spread of the virus.  You will be asked to complete a symptom screening in advance of each class.  All participants are required to wear masks upon building entry and exit, and in order to use the washroom.  Masks are not required once participants are positioned on their mats while exercising.  You are required to supply your own mat, writing utensil, and any other props you require for practice, as shared equipment will not be provided.  No more than 10 people including the teacher will practice in the studio while maintaining 2 metres of physical distance between one another, as advised by Wellington Dufferin Public Health Section 22 Class Order Pertaining to Fitness Facilities/Gyms.  You agree not to attend class if you or anyone in your family or people you have been in contact with are showing signs or symptoms of COVID-19.  By attending indoor fitness classes, you agree and understand that there is an increased risk of being exposed to or becoming infected with COVID-19 and you voluntarily assume the risk that personal injury, illness, permanent disability or death may occur as a result.  You assume the risks related to the contagious nature of COVID-19 and will not hold Dr. Kirstie Griffiths Chiropractic & Yoga liable for any illnesses related to COVID-19.

I confirm that I have had sufficient time to read and understand each item of this Waiver and Consent in its entirety, and agree to be bound by its terms freely and voluntarily.