Name
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First Name
Last Name
Email
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Phone
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What is your home base location?
Rochester, NY
Syracuse/Skaneateles, NY
Zoom (Abroad)
Tuition Plan
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$250 Deposit + $2650 Pay in Full Due by Sept 14th
$250 Deposit + 6 Monthly Payments of $475
$250 Deposit + 10 Monthly Payments of $285
I would like to discuss partial tuition relief/scholarship opportunities
How did you hear about us?
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Please affirm the student agreement by checking the box below
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The purpose of this disclosure and release (the “Waiver”) is to communicate the risks of participating in Yoga, Dance, Self-Discovery, Meditation and Training classes.
By clicking below you agree to the terms below and release Atha Yoga and Danielle Rinallo of liability. 1. Our yoga offerings may involve but are not limited to the following activities: Yoga poses, stretching, dynamic movements, breathing and breathwork, meditation and self-inquiry, and spiritual discovery. In-person classes may involve receiving hands-on assistance from teachers or program assistants, so please advise in advance if you do not consent to hands-on touch. This Waiver applies to any Atha Yoga classes made available online, live or recorded. The Waiver also applies to any off-site classes hosted or co-hosted by Atha Yoga, including classes held at other facilities or offered outdoors. 2. By choosing to participate in any class, workshop, training, or yoga journey, you voluntarily, knowingly, and expressly assume the risk of any injury. It is your responsibility to monitor your activity to determine whether it is appropriate for you. Although your teacher will guide you, you remain solely responsible for your safety and well-being. If at any point you feel overexertion, pain, or fatigue, you will rest and communicate with the facilitator as soon as possible. 2.1. Participating in online classes, live or recorded, means that there will be no in-person supervision, which presents increased risks. You acknowledge these risks and agree to participate to the extent that it is safe and reasonable for you to do so, at your own discretion. 2.2. You understand that if you are partaking in these activities outside the studio, especially at an off-site location or outdoors, there may be other reasonable and often unavoidable external risks that can arise from the new location. The following guidelines may help you reduce risk of injury in all scenarios: • Listen to and follow your teacher carefully. • Breathe smoothly and continuously as you move • Work gently, respecting your body’s abilities and limits. • Do not perform postures or movements that are painful; do not strain your body. • Ask your instructor if you are unsure how to perform any movement. 3. Each teacher reserves the right to refuse participation by any student who behaves in any dangerous, threatening, distressing, or disruptive manner. 4. Consult your physician before engaging in any physical program. Inform your instructor of any health condition(s) that may be affected by your practice of Yoga. You represent and warrant that you are physically and mentally able, and have no medical or mental health condition that would prevent your full or adaptive participation in any Yoga class. If you have not sought such advice, you must be certain that your medical and fitness levels are sufficient to participate in our classes. In consideration for your participation in any class, workshop and/or training, and by signing this form, you, your heirs, your assigns and your legal representatives hereby forever release, waive, discharge, indemnify, hold harmless and covenant not to sue Atha Yoga, it's owners, and independent contractors from all injuries, damages, losses, expenses, attorneys’ fees, settlements, liabilities, claims, suits and causes of action which may result therefrom, and which may affect you and/or Atha Yoga.
I affirm this student agreement