Before taking classes or workshops with Holistic Therapy & Wellness, PLLC and/or Savanna Scott, all adult students and parents/guardians of kids under 18 must agree to the following Waiver and Release Agreement. Please complete the form at the bottom of this page to submit your electronic signature. By submitting this form you consent to electronic communication, and all of our privacy practices can be found here.
Waiver and Release Agreement
As the student taking classes or workshops with Holistic Therapy & Wellness, PLLC and/or Savanna Scott (herein called "HTW/SS"), I understand that HTW/SS classes include physical movements and exertion. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in HTW/SS classes, whether in-person or online. I represent and warrant that I am in good health and physical condition and I have no medical condition which would prevent my full participation in HTW/SS classes, whether in-person or online. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant/become pregnant/am post-natal, if I am post-surgical, or if I am under medical care for any reason, my signature below verifies that I have my physician’s approval to participate. In consideration of being permitted to participate in HTW/SS classes, whether in-person or online, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program. In further consideration of being permitted to participate in HTW/SS classes, whether in-person or online, I expressly irrevocably release and waive any claims that I have now or may have hereafter for any reason against Holistic Therapy and Wellness, PLLC, Savanna Scott, its owners, employees and independent contractors, for injury or damages that I may sustain as a result of participating in a HTW/SS class, whether in-person or online.
For Parents Registering Children for Kids Classes, Workshops, or Camp: I am the parent and/or guardian of the minor child/children for whom I am registering. I have read this release and permission and fully understand its contents, and I have the full right and authority to execute this release and permission.
Photos: I may be photographed during yoga classes and these photographs may appear in HTW/SS promotional materials unless otherwise specified. No person whose photograph is used will be identified by name, nor will any compensation be extended for such use.
By completing the form below, I acknowledge and agree to all of the above, and I acknowledge that my submission constitutes an electronic signature and is legally enforceable as such.