I hereby agree to the following: 

1. I am participating in Yoga Therapy Sessions and/or Classes offered by Kirsten Stang and Mirabilia Yoga, during which I will receive information and instruction about Yoga including but not limited to physical exercise, meditation, chanting, breathing techniques, and hands-on adjustments. 

2. I recognize that yoga requires physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. If I experience any pain or discomfort, I will listen to my body and inform my instructor. 

3. I understand that Yoga Therapy is not a substitute for medical attention, examination, diagnosis or treatment. I affirm that I alone am responsible for deciding whether to practice Yoga Therapy. In addition, I understand that it is my responsibility to consult with a physician prior to and regarding my participation in Yoga Therapy. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate. Kirsten Stang is a Yoga Therapist and is not a licensed physician, therapist, counsellor, or psychologist. No guarantees are being made or implied regarding the efficacy of Yoga Therapy.

4. In consideration of being permitted to participate in Yoga Therapy, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program.  

5. In further consideration of being permitted to participate in Yoga Therapy, I knowingly, voluntarily, and expressly waive any claim I may have against Kirsten Stang and Mirabilia Yoga for injury or damages that I may sustain as a result of participating in Yoga Therapy.

6. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue Kirsten Stang or Mirabilia Yoga for any injury or death caused by their negligence or other acts. 

7. I understand that Kirsten Stang adheres to the IAYT Code of Ethics and Professional Responsibilities, which I can see at any time.

8. Confidentiality & Privacy: I understand that any personal information I choose to share will only be used to help Kirsten Stang provide the highest quality services and support possible. I can access my personal information at any time and understand that it will be kept confidential and destroyed after seven years, with the following exceptions: It is shared with a clinical supervisor, subpoenaed by the courts, and/or if there is a child at risk. 

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.