Register for Yoga Class

printable version

Below is an application that can be printed then filled out and brought in or mailed in with your payment.

You can mail in your payment to:

Inner Peace Yoga Center

5038 E. 56th St

Indianapolis, IN 46226

If you are registering for the Carmel Class please check here_______

You may also pay with VISA, MASTER CARD and DISCOVER

NAME________________________________________________________

ADDRESS_____________________________________________________

CITY_____________________________STATE_________ZIP___________

PHONE (h)__________________(w)________________(cell)____________

EMAIL (optional)________________________________________________

1st Class Choice: Level___________________Day________Time_________

2nd Class Choice: Level___________________Day_________Time_________

Known physical limitations_________________________________________

In consideration for permission to participate in, today and on all future dates, yoga instruction and classes at Inner Peace Yoga Center I, the undersigned, expressly agree:

1. That I am physically sound to proceed with instruction in yoga. I hereby assume any and all risks involved in the exercise and instruction of yoga, including, without limitation, physical injury.

2. TO RELEASE Inner Peace Yoga Center and any of its owners, employees and agents from, and AGREE NOT TO SUE ANY OR ALL OF THEM on account of or in connection with any claims, causes of action, injuries, damages, costs or expenses arising out of my participation in yoga classes or lessons, or my presence upon the premises of Inner Peace Yoga Center, including, but not limited to those based on bodily injury, whether or not caused by the negligence or other fault of Inner Peace printeYoga Center.

3. I also understand my deposit and tuition are non-refundable and neither may be applied toward any future semester.I HAVE READ AND UNDERSTOOD THIS AGREEMENT. I UNDERSTAND THAT BY MAKING AND SIGNING THIS AGREEMENT, I SURRENDER VALUABLE RIGHTS, INCLUDING, BUT NOT LIMITED TO, MY RIGHT TO SUE. I DO SO FREELY AND VOLUNTARILY.

Signature_____________________________________

Date___________________