Full Name of Participant *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number (cell preferred) *

We will only call you or text you in extenuating circumstances, or to let you know if a class you registered for is cancelled or rescheduled.

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone Number (cell preferred) *

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If Participant is Under 18 *

As Parent or Legal Guardian of above Participant, I consent to the below terms and conditions as I click "I accept" and submit this form.

First Name

Last Name

*

I hereby WAIVE AND RELEASE Country Flow Yoga Studio LLC, its owners, officers, employees and instructors from any claim, demand, cause of action of any kind resulting from or related to my participation in the classes, programs offered at the facility. In taking part in the yoga classes, programs, workshops or other activities sponsored or hosted by Country Flow Yoga Studio LLC, I understand and acknowledge that I am fully responsible for any and all risks, injuries or damages, known or unknown, which might occur as a result of my participation in the classes, programs, workshops or other activities. I have read the above release and waiver of liability and fully understand its content. I am legally competent to sign and voluntarily agree to the terms and conditions stated above. Please participate mindfully and enjoy the many benefits of practicing yoga. *

I am aware that by checking this box and by clicking submit on this form I am submitting my signature on this form.