WAIVER OF LIABILITY, RELEASE, ASSUMPTION OF RISK, INDEMNITY & CONSENT AGREEMENT

I wish to participate in “Activities” offered by Pistachio Yoga, LLC, its staff, and/or its “Yoga Instructors” both online and in-person at 5206 N. Damen Ave., Chicago, IL 60625, OR at a “Special Event” facility. (“Activities” is understood herein to mean the full range of activities to be offered by Pistachio Yoga LLC, including but not be limited to: yoga poses, yoga classes, static positions, posture alignment, workshops, personal coaching, dance yoga, or any other events and/or “Special Events”; also my use of the facilities at 5206 N. Damen Ave., Chicago IL 60625, OR at a

“Special Event” facility, including presence/ travel within that facility related to these “Activities”). (“Yoga Instructors” herein are understood to be independent contractors, not employees of Pistachio Yoga, LLC, also

taking part in the stated “Activities,” and are subject to this same Legal Agreement) (“Special Event” herein is understood as any “Activities” at a location other than 5206 N. Damen Ave., Chicago, IL 60625, whether one time or recurring).

As a precondition to participating in said “Activities”, I have read the following WAIVER OF LIABILITY, RELEASE, ASSUMPTION OF RISK, INDEMNITY AND CONSENT AGREEMENT (hereinafter “Legal Agreement”) and acknowledge that I understand and agree to its terms.  Most importantly, I acknowledge and understand the nature of the “Activities” that I will be participating in and the possibility that despite all the precautions taken by Pistachio Yoga, LLC, all hazards cannot be foreseen nor prevented – such that accidents, illness, or injury may still occur. Depending on the particular activity, certain risks, dangers and injuries due to overexertion, lack of hydration, improper technique, ignoring safety precautions, failing to properly follow instructions, slips and falls, unfamiliarity with the equipment/exercise, equipment failure, failure in supervision/instruction, premises defects and other risks inherent to the particular activity exist.  Depending upon a person’s physical condition, age and/or skill level, “Activities” can involve a substantial risk of the following types of injuries, among others: (i) bone and joint injuries, (ii) back and neck injuries, (iii) muscle strain and other muscle injuries, or (iv) economic loss.  In consideration for the right to participate in “Activities” provided by or at Pistachio Yoga LLC (the sufficiency of which I acknowledge), I hereby, for myself, my heirs, executors, administrators, assigns or personal representatives, knowingly and voluntarily enter this “Legal Agreement.”  I understand that this Legal Agreement is a release of legal rights and that I have read and understood it prior to signing!

WARRANTY OF PHYSICAL FITNESS

I understand that the “Activities” require physical exertion, flexibility, and cardiovascular exertion.  I acknowledge that “Activities” may involve a test of a person’s physical and mental limits and may carry with it the potential for injury.  The risks may include, but are not limited to those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, traffic and action of others, including other participants and/or students.  I warrant and represent that I am physically fit and in a condition that will allow me to participate fully in the “Activities.” I further warrant that I know of no pre-existing medical condition affecting my fitness. I understand I should carry my own medical insurance that covers me for accidents and illness while I am participating in the “Activities” of Pistachio Yoga LLC.  I understand that Pistachio Yoga LLC has not made nor will make any investigation into my physical fitness or ability to participate in the “Activities” and that Pistachio Yoga, LLC, its staff and ”Yoga Instructors” are relying on my warranty of my physical fitness/condition. It is my responsibility to inform the “Yoga Instructor” of any physical or fitness limitations before class or “Activities” begins. I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension, with sweating, shortness of breath, and soreness expected and likely. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the instructor. I will refrain from any movement that I am unable to do or are uncomfortable with.

MEDICAL CLEARANCE

I affirm that I have medical clearance from my physician-primary care, psychologist and psychiatrist who has verified my good health and physical condition to participate in “Activities”; OR If I am pregnant, become pregnant or I am post-natal or post-surgical, and/or if I have a known pre-existing cardiac condition, I warrant and verify that I have my physician's approval to participate in “Activities” of Pistachio Yoga, LLC, notwithstanding that medical condition/pregnancy and understand that Pistachio Yoga LLC, its staff, and “Yoga Instructors” are relying on my warranty of medical clearance.  I will exclude myself from “Activities” if at any time I lack medical clearance to continue.

ASSUMPTION OF RISK

I affirm that I alone am responsible to decide whether to engage in “Activities” at Pistachio Yoga, LLC and that I am participating voluntarily at my own risk.  I am aware of the risks associated with travelling to and from as well as participating in “Activities”, which may include, but are not limited to: physical or psychological injury, pain, suffering, illness, economic or emotional loss.  I understand that these injuries may arise from my own or others’ negligence (including failure to supervise), conditions of the premises, and/or personal conditions (including lack of hydration and lack of familiarity). Nonetheless, I assume all related risks, both known or unknown to me, of my participation in the “Activities”, including travel to, from and during the “Activities.”

LIABILITY RELEASE, WAIVER & INDEMNIFICATION

In consideration for Pistachio Yoga, LLC allowing me to participate in “Activities,” I agree I will not sue Christianne Reynoso, Pistachio Yoga, LLC, and/or its Landlord, staff, “Yoga Instructors,” owners, agents, assigns and successors and I release Christianne Reynoso, Pistachio Yoga, LLC, and/or its Landlord, staff, “Yoga Instructors,” owners, agents, assigns and successors from any and all liabilities, claims demands, actions, causes of action, costs, and expenses, of any nature whatsoever arising out of loss, damage, or injury, including death, that may be sustained by me or to me or to any property belonging to me, arising from the “Activities” or while on the premises where the “Activities” are being conducted by Pistachio Yoga, LLC, and its staff, and/or “Yoga Instructors,” excepting those claims arising from the gross negligence or willful conduct of Pistachio Yoga, LLC.

I agree to indemnify and hold harmless Christianne Reynoso, Pistachio Yoga, LLC, and/or its Landlord, staff, “Yoga Instructors,” owners, agents, assigns and successors from any and all loss, liability, damage or costs, including court costs and attorneys’ fees that they may incur arising from my involvement in the “Activities” or while on the premises where the “Activities” are being conducted by Pistachio Yoga, LLC, and its staff, and/or “Yoga Instructors,” excepting those claims arising from the gross negligence or willful conduct of Pistachio Yoga, LLC.

CONSENT

I understand that in the course of “Activities” it may become necessary for Pistachio Yoga LLC, its staff, and/or “Yoga Instructors” to physically touch me to assist with poses, posture alignment, and any other variation of hands-on modification that is commonly performed in the field of yoga.  I understand that performing yoga and “Activities” with improper alignment may cause injury to me and that hands-on modification commonly performed in the field of yoga, “Yoga Instructors” are attempting to minimize the risk of such injury.  I consent to such touching and acknowledge that if I decide to withdraw my consent at any time, I need to make it explicitly known to each “Yoga Instructor” at that time.  

EMERGENCY MEDICAL TREATMENT

I grant Pistachio Yoga LLC, and its staff and “Yoga Instructors” permission to authorize emergency medical treatment (including contacting an Emergency Medical Transport Ambulance) as it deems appropriate and agree that such actions shall be subject to the terms of this Agreement. I understand and agree that Pistachio Yoga LLC, its staff and/or “Yoga Instructors” assume no responsibility for any injury or damage or cost that might arise out of or in connection with the aforesaid authorized emergency medical treatment. I will be solely and personally responsible for payment for any and all medical services rendered and for the cost of travel to and from the place of medical treatment.

SAFEGUARDING BELONGINGS

I acknowledge that Pistachio Yoga, LLC, its staff, and/or “Yoga Instructors” bear no responsibility nor liability for storage of my personal belongings during “Activities.” I hereby assume all risk of damage, or loss to my property including, any loss or theft of any personal property or belongings.  

INTENT

I agree that the foregoing “Legal Agreement” is intended to be as broad and inclusive as permitted by law in the State of Illinois and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.  I agree this “Legal Agreement” and any claim arising from my participation in “Activities” shall be construed/enforced according to Illinois law.  

ELECTRONIC SIGNATURE CONSENT

By submitting my e-signature via this electronic form this is to be understood as my free and voluntary choice to consent to the use of “e-signatures” in accord with Illinois Public Act 102-0038 (2021). I understand that I have the option to decline “e-signatures” and expressly waive such an option, preferring to utilize this form and “e-signatures” (including if I am not located in Illinois). 

SIGNATURE AND AFFIRMATIONS

By way of my e-signature below I give proof of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein, and confirm my agreement to the terms detailed above.  I further warrant and affirm that the Date of Birth and ID submitted to Pistachio Yoga LLC are my own.  I hereby affirm that I am at least 18 years of age and that I am freely signing this Agreement.

I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO SIGNING, AND UNDERSTAND I AM GIVING UP THE RIGHT TO BRING A LAWSUIT FOR INJURIES/LOSSES ARISING FROM MY PARTICIPATION IN “ACTIVITIES” OF PISTACHIO YOGA, LLC. NO ORAL REPRESENTATIONS HAVE BEEN MADE TO ME TO OBTAIN MY SIGNATURE

5
*
Powered by