Application

Which Program 200 hr 500 hr Other

Name
 

Age
 

Email
 

Phone Number
 

What is your relationship to yoga?

How long have you been practicing and in what tradition or lineage?

On a typical week what does your practice consist of?

Are you currently teaching and if so where and for how long?

What is it you would most like to gain from this Yoga intensive? What are your strengths and weaknesses that you would bring to the program? Honestly, what expectations do you have?

Are there any health related conditions you have that we should know about? For example: high blood pressure, diabetes, anxiety, depression, and physical injuries, medications, etcetera

Is there anything else you would like to tell us?

How did you hear about us?
 Friend Word of Mouth Internet Search Facebook AD Google AD Print Media

All participants in Axis Yoga Trainings program are required to agree to the following waiver of liability in order to participate in the program. You cannot submit your application without reading and accepting this waiver of liability by checking the box below.

Release and Waiver of Liability:

1. I warrant that I am over 18 years of age, in good health, and have no physical or mental condition that would prevent me or render it inadvisable for me to participate in the yoga intensive and teacher’s training program.

2. In consideration of receiving permission to participate in this program, I, for myself and for my personal representatives, heirs and next of kin, hereby agree to release and discharge from any liability whatsoever, and waive any and all claims I may have against any person or entity involved with this program in any manner, including but not limited to the Denver Institute of Yoga, Axis Yoga Trainings, Derik Eselius, Derik Eselius LLC, Brenna Hatami, Brenna Hatami LLC, Kevin Durkin, Steven Powell, Kim Johnson, Beth Sanchez and Mark A. Sisun and each of their agents, employees, students and representatives, as a result of any injury or damage, including death, sustained by me or to my property while participating in this program, whether caused by the negligence of any of the above named parties or others, and whether foreseen or unforeseen.

3. I understand that not all yoga exercises or practices are suitable for everyone and that participation in the suggested exercises and practices may result in injury. With the knowledge that any of these exercises and practices can result in injury, I hereby expressly assume all risks associated with participation in this program, including the risk of injury or damage resulting from performing any of these exercises and practices.

4. I further agree to indemnify and hold harmless any of the above named parties from any claim by or against me arising out of my participation in this program, including all of their attorney’s fees and costs.

5. I understand that the instruction and advice presented in this program is not intended as a substitute for medical advice and counseling, and that one should consult a physician prior to the start of any new exercises or practices. I consent to and permit emergency treatment, medical or other wise, in the event of injury or illness. I further release all persons associated with this program in any manner from any claim whatsoever on account of treatment or service rendered to me during this program.

 I Agree to the terms of the waiver of liability

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