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I desire to engage voluntarily in AT Sangha Yoga LLP yoga & fitness sessions in order to attempt to improve my wellness.
I understand that the purpose of the yoga movement programs is to develop and maintain overall wellness, flexibility, joint mobility and decrease stress. All sessions include warm-up, breathing and movement with modifications if needed. The programs include, but are not limited to gentle yoga, vinyasa yoga, yin yoga, restorative yoga, yoga nidra, parent and child yoga & various fitness and mindfulness modalities.
I understand that I am to listen to the feedback my body is giving me and responsible for monitoring my own condition & throughout the session, should any pain occur, I would cease my participation and inform the instructor.
In signing/acknowledging this consent form, I affirm that I have read this form in its entirety and I understand the nature of the program. I also affirm that my questions regarding the program have been answered to my satisfaction.
In the event that medical clearance must be obtained prior to my participation in the program, I agree to consult my physician and obtain written permission from my physician prior to the commencement of any exercise program.
I also give my permission to allow photos of me be taken during class sessions to be used solely for the purpose of AT Sangha Yoga LLP/ Women’s Wellness LLC marketing purposes.
Also, in consideration for being allowed to participate in this exercise program, I agree to assume the risk of such exercise, and further agree to hold harmless AT Sangha Yoga LLP and Women’s Wellness LLC, it’s employees and agents from any and all claims, suits, losses or related caused of action for damages, including, but not limited to, such claims that may result in my injury or death, accidental or otherwise, during or arising in any way from the sessions.
- I desire to engage voluntarily in RUSHLOW WELLNESS LLC/AMY RUSHLOW yoga & fitness sessions in order to attempt to improve my wellness.
- I understand that the purpose of the movement programs is to develop and maintain overall wellness, flexibility, joint mobility and decrease stress. All sessions include warm-up, breathing and simple movement. The programs include, but are not limited to gentle yoga, restorative yoga & various fitness modalities.
- I understand that I am to listen to the feedback my body is giving me and responsible for monitoring my own condition & throughout the session, should any pain occur, I would cease my participation and inform the instructor.
- In signing this consent form, I affirm that I have read this form in its entirety and I understand the nature of the program. I also affirm that my questions regarding the program have been answered to my satisfaction.
- In the event that medical clearance must be obtained prior to my participation in the program, I agree to consult my physician and obtain written permission from my physician prior to the commencement of any exercise program.
- I also give my permission to allow photos of me be taken during class sessions to be used solely for the purpose of Rushlow Wellness LLC marketing purposes.
- Also, in consideration for being allowed to participate in this exercise program, I agree to assume the risk of such exercise, and further agree to hold harmless Rushlow Wellness LLC, Amy Rushlow, and her heir’s, it’s employees and agents from any and all claims, suits, losses or related caused of action for damages, including, but not limited to, such claims that may result in my injury or death, accidental or otherwise, during or arising in any way from the sessions.
- I understand that coaching is a broadly inclusive process that may include different areas of my life including and not limited to health, professional or family relationships and work. I acknowledge that it is my decision and choice how to utilize information in these areas in coaching sessions. It is my responsibility.
- I understand and agree that I am responsible for my physical, mental and emotional well-being during my coaching appointments. These appointments may take place in person, by phone, or video call. Any choices I make or injuries that I incur from recommendations made during my coaching appointments are fully my responsibility.
- TAKING BREAKS and TERMINATION: I agree and understand my coach or I can terminate or discontinue coaching at any time. If I need to cancel or change the time of a coaching appointment I understand I need 24 hours notice in order to not to be charged for the session. With advance notice of more than 24 hours I will not be charged and I will make every effort to reschedule.
- CONFIDENTIALITY: I understand that in order to protect my privacy, if I terminate my coaching, any assignment work or information about our coaching sessions will be deleted from my coach’s files. I also agree that I consent to using e-mails to sometimes transmit sensitive information. I acknowledge the risks involved and waive any rights against my coach for errors made in these transmissions.
- NON-DISCLOSURE and INTELLECTUAL PROPERTY: I understand that the methodology, coaching techniques and strategies used, as well as assignments, documents or emails are proprietary and I understand that and agree that they may not be used for any other purposes other than my coaching appointments without written consent from my coach. I understand that information is held as confidential to fulfill my coaching obligations and as required by law.
- DEFINITION of COACHING: I understand that coaching is intended for individuals who want to take action and make behavior changes in the service of their goals for life, health, well-being or work. Coaching does not involve the diagnosis or treatment of physical or mental disorders and I will not use it in place of any other diagnosis, therapy or treatment for other advice given me by medical, legal, financial or other qualified professional. It is clear that coaching may not be appropriate for all people.
- LIABILITY: Total liability under this coaching agreement shall be limited to the total amount actually paid by a client to the coach. In no event shall the coach be liable for any consequential or indirect damages alleged to result from the coach’s performance or obligations under this agreement. I understand, acknowledge and agree that limited liability is a fundamental part of this agreement. The fees charged in this coaching agreement reflect the risk agreed upon by both client and coach. No action, regardless of nature arising from coaching services may be brought by the client, more than one (1) year after services rendered.
This section covers coaching and life coaching services given by RUSHLOW WELLNESS LLC/AMY RUSHLOW. By engaging in related services, you hereby agree to the following:
- I understand that life coaching is a relationship I have with my coach designed to facilitate the creation/development of my best life, and what I express how my coach can assist. I understand that life coaching is a comprehensive process that may involve all areas of my life and could include work, finances, health, relationships, education, activities and that deciding what to do in these realms is my responsibility.
- I understand that information I give to RUSHLOW WELLNESS LLC/AMY RUSHLOW is confidential unless I state otherwise, in writing. However, I understand that if I report abuse, neglect or threaten to harm myself or someone else, necessary actions will be taken and my confidentiality agreement will not limit this capacity.
- As a client, I understand and agree that I am fully responsible for my well-being during my coaching sessions, including my decisions and choices. I may discontinue my coaching sessions with RUSHLOW WELLNESS LLC/AMY RUSHLOW at any time. I know that coaching is not psychotherapy, counseling or any medical alternative. I understand coaching is not a substitute for counseling, psychotherapy, mental health and will not use it in place of any form of therapy or medical advice. I agree I am well adjusted, mentally healthy and ready for coaching. It is my responsibility to consult my health care provider prior to participating in coaching with RUSHLOW WELLNESS LLC/AMY RUSHLOW. Should I choose not to consult my primary health care provider, I accept full responsibility & waive all rights to liability or any claims against RUSHLOW WELLNESS LLC/AMY RUSHLOW or any affiliated administrators, or employees. I, release the organization or business named above from all liability, costs and damages which might arise from participation in the above-named event or activity.
- I forever release RUSHLOW WELLNESS LLC/AMY RUSHLOW from any and all actions, claims or demands that I, my assignees, heirs, distributes, guardians, next of kin, spouse and legal representatives now have or may have in the future, for injury, death, or property damage, related to my participation in this activity or for the negligence or other acts, whether directly connected to this activity or not. I agree, I the client, would be responsible for attorney fees for all parties if lawsuit filed.
- I understand that I am responsible for the fees if I cancel less than 24 hours. Missed sessions will not be made up.
- I am choosing to participate in coaching services with RUSHLOW WELLNESS LLC/AMY RUSHLOW. Any suggested Yoga Poses, Meditation or Reading Material is just a suggestion. It is my choice to perform or read any suggested material and I do them at my own risk.
- RUSHLOW WELLNESS LLC/AMY RUSHLOW is not a physician, and the scope of the consultation services does not include treatment or diagnosis of specific illnesses or disorders. If you, the client, suspect you may have an ailment or illness that may require medical attention, then you are encouraged to consult with a licensed physician without delay.
- Rather than dealing with the treatment of disease, RUSHLOW WELLNESS LLC/AMY RUSHLOW focuses on wellness and prevention of illness through proper diet and nutrition to achieve optimal health. RUSHLOW WELLNESS LLC/AMY RUSHLOW primarily educates and motivates clients to assume more personal responsibility for their health by adopting a healthy attitude, lifestyle, and diet.
- While people generally experience greater health and wellness as a result of embracing a healthier attitude, lifestyle, and diet, RUSHLOW WELLNESS LLC/AMY RUSHLOW does not promise or guarantee protection from future illness.
- By signing below, you acknowledge that you understand that RUSHLOW WELLNESS LLC/AMY RUSHLOW is a health consultant and not a physician and that you should see a doctor if you think you have a medical condition. RUSHLOW WELLNESS LLC/AMY RUSHLOW will not be held liable for failure to diagnose or treat an illness, nor will she be liable for failure to prevent future illness.
- Additionally, you promise to give RUSHLOW WELLNESS LLC/AMY RUSHLOW a complete and accurate account of any medical conditions that you may have and any medications that you are taking.
- That I am participating in Iceland 2022 Retreat offered by RUSHLOW WELLNESS LLC/AMY RUSHLOW. I recognize that this retreat/event may require physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
- I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Retreat. I represent and warrant that I am physically fit and I have no medical conditions that would prevent my full participation in the Retreat.
- I understand that if I am pregnant, I will take the necessary steps to ensure my doctor and health care providers know I am participating in this Retreat. I assert that I am of fit health to participate in the Retreat and will alert all potential teachers whose sessions I participate in that I am pregnant.
- In consideration of being permitted to participate in the Retreat, 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 retreat, including any and all activities done with the Retreat group, or as an individual on the way to, in or from Iceland.
- In further consideration of being permitted to participate in the Iceland 2022 Retreat, I knowingly, voluntarily and expressly waive any claim I may have against RUSHLOW WELLNESS LLC/AMY RUSHLOW its staff, employees, or agents for injury or damages that I may sustain as a result of participating in the retreat. I, my heirs and legal representatives forever release, waive, discharge and covenant not to sue RUSHLOW WELLNESS LLC/AMY RUSHLOW, it’s staff, employees, or agents for any injury or death caused by their negligence or other acts.