Providence Hill Farm Aerial Yoga Waiver & Release

Full Name*

E-mail*

Phone Number*

Acknowledgment of Risk

I understand that participation in aerial yoga and related activities involves inherent risks, including but not limited to: falls or loss of balance muscle strain, sprain, or injury joint stress or aggravation of existing conditions dizziness, disorientation, or changes in blood pressure

I understand that the use of aerial equipment, including hammocks and suspension systems, adds an additional element of instability and requires personal awareness and responsibility.

Medical Considerations & Contraindications

I acknowledge that I am responsible for determining whether this activity is appropriate for me.

I understand that aerial yoga may not be suitable for individuals with certain conditions, including but not limited to: uncontrolled high or low blood pressure glaucoma or other eye conditions affected by pressure recent surgery or acute injury severe vertigo or balance disorders spinal instability or acute disc issues joint instability or recent joint replacement pregnancy (unless cleared by a qualified healthcare provider)

List any relevant medical conditions

I confirm that I have disclosed any relevant medical conditions and will inform the instructor of any changes.

Personal Responsibility

I understand that I am responsible for my own body at all times.

I agree to: listen to my body and respect its limits take breaks whenever needed stop any movement that causes pain, dizziness, or discomfort ask questions if I am unsure about any instruction

I understand that the instructor is a guide and cannot feel what I am experiencing in my body.

Instruction & Participation

I agree to follow all safety instructions and guidelines provided.

I understand that: participation is voluntary I may choose to opt out of any movement or activity at any time modifications are available and encouraged

Release of Liability

In consideration of being allowed to participate, I voluntarily assume all risks associated with this activity.

I hereby release and discharge Providence Hill Farm, Christy Harris, and any associated instructors or assistants from any and all liability for injury, loss, or damages arising from my participation, except in cases of gross negligence.

Photo & Media Release

I consent to photos or videos taken during the session being used for promotional purposes.

I do not consent to photos or videos being used.

Acknowledgment

By checking this box, acknowledge that I have read, understood, and agree to the terms of this waiver.

I understand that I am participating at my own risk and that I am responsible for my own well-being throughout the practice.

Date *

Date