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
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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Participant Waiver and Release of Liability
The purpose of this disclosure and release is to communicate the risks of participating in yoga, movement, and teacher training classes at Atha Yoga.
⚠️ Acknowledgment of Risk
Our yoga offerings may involve but are not limited to the following activities:
Yoga asana (postures), light stretching, dynamic movements, breathing and breathwork, meditation, self-inquiry, and spiritual discovery.
In-person classes may involve receiving hands-on assistance from your direct teacher or program assistants. If you do not want hands-on touch, advise us before the start of class via email to danielle@athayogaom.com or verbally direct to your teacher. You may also advise us at the time of the assistance if you do/do not consent to the hands-on support at that moment. You can change your mind any time and have full agency to choose, and communicate that choice.
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.
By choosing to participate in any of our yoga classes or trainings, you voluntarily, knowingly, and expressly assume the risk of any injury. You assume responsibility for monitoring 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 your facilitator as soon as possible.
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. 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 the risk of injury in all scenarios:
• Listen for your teacher's guidance to practice safely and effectively.
• Breathe smoothly and continuously as you move, to monitor your exertion.
• Work gently, steady breath while exploring, and respect your abilities and limits.
• Ask your instructor if you are unsure how to engage with the current instruction.
• Full agency to opt out of movements or exercises as needed.
Each teacher reserves the right to refuse participation by any student who behaves in any dangerous, threatening, distressing, or disruptive manner.
Consult your physician before engaging in any physical program. Inform your teacher of any health condition(s) that may be affected by your practice of Yoga.
📝 Release of Liability
By acknowledging 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.
📸 Media Release
You grant permission for photos, videos, or recordings of you taken during these classes, trainings and events to be used for promotional, educational, or archival purposes by Danielle Rinallo & Atha Yoga.
If you have any questions about this waiver, accessibility, or participation, reach out to danielle@athayogaom.com
We look forward to this journey with you!
I affirm this student agreement and agree to the terms and agreements above