New Student Waiver

Hello friends and family of Cheryl + Hardy Whiteman. As you celebrate Cheryl's life, may this yoga practice be an opportunity for us to set our intentions for how we feel and treat ourselves and others at all times, but especially when we are dealing with difficult circumstances and feeling loss. I'm honored to have an opportunity to lead you through a practice and help you create space for all that is to come. 

All students will be required to complete a Health Disclosure and Release waiver before attending classes or workshops with Shelby Kruse. This serves as a way for me to get to know you and your needs a little better, as well as providing me with the necessary paperwork required by my liability insurance.

Please know I treat all information provided here, in conversation, or practice as privileged and confidential and will not release it without your consent. Ever. 

Please reach out to me before class with any questions or concerns and I promise to do the same. You can email me at hello@shelbykruse.com. I'm looking forward to meeting you.

 

Please complete the form below

Name *
Name
Phone *
Phone
What number can we reach you at if we need to discuss this form?
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
If no, skip the next two questions.
Due Date
Due Date
Please include any medication, injury or medical conditions that might require you to limit physical activity.
Describe your experience with yoga. *
Mark all that apply.
I, the participant, understand that the yoga sessions and other sessions taught by Shelby Kruse of Yoga + Oils are for the purpose of stress reduction, relief from muscular tension, and/or for increasing strength, flexibility (range of motion), circulation, energy flow, and relaxation. I agree to take full responsibility for not exceeding my personal limits, physical or otherwise, in my practice and for any injury I might suffer during my participation in the sessions. It is my full and complete responsibility to ascertain if a medical condition should prevent or limit my participation in certain poses or exercises. I have stated all of my known medical conditions and agree to keep the yoga teacher updated on my health. I, the participant, further understand that yoga is a physical activity that can cause physical injury, mental and emotional changes, and other physiological changes and I herewith by my signature release Yoga + Oils and Shelby Kruse from any and all legal claims resulting from said injuries and changes. I grant full permission for organizers to use my name, likeness, or voice and photographs, videotapes, or quotations from me in accounts and promotions for any medium of the activities of Yoga + Oils. 
I, the participant, have carefully read and completed this Disclosure and Release Form and fully understand its content and voluntarily agree with all of the content.