Yoga Release Form
A yoga release form is authorized form filled between an interested yoga participant and a yoga instructor/ trainer/ nurse in order to acknowledge the participation of a candidate by understanding the health risks & injuries associated with different yoga postures.
Sample Yoga release form:
Details of the Yoga Participant:
Full Name of the Participant: ____________________
Date of Birth: ____/ ____/ _____
Sex: ________________________
Height ___________________________
Weight _____________________________
Street Address: ________________ City: _______________ State: _________________ZIP: _______________
Phone Number: __________________
E-mail id: _______________________
Occupation: _____________________
Professional details of the Yoga trainer:
Name: _______________________
Address: _____________________ ZIP: ____________________
Phone Number: ____________________
E-Mail Id: _____________________
Website Address if any: ______________________
Yoga Release Declarations:
Type of participant: ______________ Voluntary/ Permanent for some duration
Has the yoga participant as mentioned above understood all risks & benefits associated with these yoga sessions: _________________ Yes/ No
Is the Yoga Participant suffering from any kind of disease & illness: _______________ Yes/ No
Please mention the details of the diseases_________________
Please mention if you are undergoing any medical treatment ____________________
Date of Yoga release: ____/ ____/ ___
Signed by the Yoga Trainer: ____________________
Signed by the Participant: ______________________
Signature of the Parent/ Guardian: __________________ (if the participant is under the age of 18)
Seal: ________________________
Category: Release Forms
