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PYTI Release of Liability

PYTI Release of Liability

This form must be filled out be each student entering Module 8 or any specialty course taught by Ginger Garner or any PTYI Faculty or TA. This form covers all PYTI on-site and specialty courses including but not limited to Module 8, Module 14, and Module 15.

  • I, the undersigned, am attending a course conducted by Living Well Inc., specifically Professional Yoga Therapy Institute for the purpose of obtaining continuing education instructions. In consideration for these instructions, which include physical therapy instructions, I hereby release Living Well, Inc., Professional Yoga Therapy Institute, Ginger Garner and her agents and assistants and agree to hold them harmless from any and all liability, claims, damages, actions and causes of action whatsoever, for loss, damages or injury to person or property, irrespective of how arising and however caused, including but not limited to all kinds and degrees or extent of negligence with which they may be charged in connection, directly or indirectly with these physical therapy instructions.

    I further agree to disclose in writing all of my physical and medical conditions, limitations and sensitivities and agree to release and hold Ginger Garner and her agents and her assistants harmless from any liability, claims, damages, actions and causes of action in any way relating to or arising from said conditions, limitations or sensitivities. I expressly agree that all physical therapy instructions and use of all facilities and equipment shall be undertaken at my own risk, and I represent that I am physically and medically able to undertake any and all physical therapy instructions provided.

    I further agree that Ginger Garner and her agents and her assistants shall not be liable for any claims, demands, injuries, damages, actions or causes of action whatsoever arising out of or connected with the use of any of its services, facilities or equipment. I hereby expressly forever release and discharge Ginger Garner and her agents and her assistants from all such claims, demands, injuries, damages, action or causes of action and from all acts of active or passive negligence on the part of Ginger Garner and her agents and her assistants.

    By selecting the below Submit button, I agree to the terms of this release of liability.
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  • Release of Liability must be signed and submitted for each Module/Course/Program registration.
  • Please describe any medical conditions, limitations, and sensitivities you may have. Please enter N/A if you have no medical conditions, limitations, or sensitivities.

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