Informed Consent (Waiver)

Print and sign this form or complete it online here.

I desire to engage voluntarily in the yoga sessions with Seanna Tracy at Swallow Creek Ranch, in order to attempt to improve my wellness.

I understand that the purpose of the movement programs is to develop and maintain overall wellness, flexibility, joint mobility and decrease stress.

All sessions include warm-up, breathing and simple movement. The programs include, but are not limited to gentle yoga, restorative yoga & various fitness modalities.

I understand that I am to listen to the feedback my body is giving me and responsible for monitoring my own condition & throughout the session, should any pain occur, I would cease my participation and inform the instructor.

In signing this consent form, I affirm that I have read this form in its entirety and I understand the nature of the program. I also affirm that my questions regarding the program have been answered to my satisfaction.

In the event that medical clearance must be obtained prior to my participation in the program, I agree to consult my physician and obtain written permission from my physician prior to the commencement of any exercise program.

I also give my permission to allow photos of me be taken during class sessions to be used solely for the purpose of Seanna Yoga marketing purposes.

Also, in consideration for being allowed to participate in this exercise program, I agree to assume the risk of such exercise, and further agree to hold harmless Seanna Tracy & Waddell-Grafton Family Limited Partnership/Swallow Creek Ranch, it’s employees and agents from any and all claims, suits, losses or related caused of action for damages, including, but not limited to, such claims that may result in my injury or death, accidental or otherwise, during or arising in any way from the sessions.

Your Name (please print): ________________________
Signature: ________________________
Address: ________________________
Phone: ________________________
eMail: ________________________
Emergency contact & phone: ________________________

Mobile users can also scan the QR below to acesss online version:

QR Code for JotForm form