top of page

We are delighted to have you as a participant of Pinnacle Yoga and Retreat Center, LLC. The following information will help you get the most out of your classes, and clarify your instructor’s role. Please read and sign below. 


*Please note, if you are filling this out for your child, you will need to create an account for them and sign on their behalf.* 


I understand that I may not participate in hot yoga classes until I am 16 years of age and anyone 16-18 must have written permission from a parent or legal guardian to participate in the hot yoga class. The parent or guardian must sign the waiver on behalf of the minor.


Participation​ ​in​ ​suspension/aerial​ ​yoga​ ​classes​ ​includes,​ ​but​ ​is​ ​not limited​ ​to,​ ​performing​ ​various​ ​suspended​ ​yoga​ ​postures​ ​and/or suspended​ ​strength​ ​training.​ ​


1. Yoga is a physical exercise that integrates mind, body and spirit. Yoga is a way of encountering and releasing physical, mental and emotional tensions to arrive at deeper levels of relaxation and awareness. 


2. By choosing to participate in any class, workshop, or retreat, you voluntarily, knowingly and expressly assume the risk of any injury. The following guidelines may help you to reduce that risk:

• Listen to and follow your instructor carefully

• Breathe smoothly and continuously as you move and stretch

• Do not hold your breath or strain to attain any posture 

• Work gently, respecting your body’s abilities and limits

• Do not perform postures or movements that are painful

• Ask your instructor if you are unsure how to perform any movement

• Pregnant women should practice only gentle forms of Yoga, and refrain from inversions, laying on the belly or the back, or compressing the belly

• If​ ​I​ ​am​ ​pregnant,​ ​or​ ​become​ ​pregnant,​ ​or​ ​am​ ​post-natal,​ ​my​ ​signature verifies​ ​that​ ​I​ ​am​ ​        participating​ ​in​ ​aerial/suspension,​ ​or​ ​any​ ​other exercise​ ​classes,​ ​with​ ​my​ ​doctor's​ ​full​ ​approval.

• Menstruating women may wish to refrain from practicing inversions

• Yoga for Cancer classes are developed specifically to consider surgeries, treatments, side effects and emotional experiences of cancer. Participants take full responsibility for their unique needs and are responsible for participating to the extent that is appropriate for them.  


3. Consult your physician before embarking on any exercise program. Inform your instructor of any health condition(s) that may be affected by your practice of yoga. You represent and warrant that you are physically fit, and have no medical condition that would prevent your full participation in any yoga class. 


4. It is your responsibility to monitor each activity to determine whether it is appropriate for you to participate. Although your instructor will guide you, you remain solely responsible for your safety and well-being. 


5. In consideration for your participation in any class, workshop or retreat, and by signing this form, you, your heirs, your assigns, and your legal representatives hereby forever release, waive, discharge, indemnify, hold harmless and covenant not to sue Pinnacle Yoga and Retreat Center, LLC and its owners, directors, officers, employees, agents, members, managers, instructors and representatives (collectively, “Pinnacle Yoga and Retreat Center, LLC”) from all injuries, damages, losses, expenses, attorneys’ fees, settlements, liabilities, claims, suits and causes of action which may result therefrom, and which may affect you and/or Pinnacle Yoga and Retreat Center, LLC. 


6. Each instructor reserves the right to refuse participation by any student who behaves in a dangerous, threatening, distressing or disruptive manner with regard to the instructor or any student. 


7. If you do not wish to receive physical assistance, it is your responsibility to inform your instructor. 


8. I hereby give my consent to Pinnacle Yoga and Retreat Center, LLC to photograph, film, videotape and then use, reproduce, and publish images of me. I agree that photographs/negatives, film, or videotapes thereof shall constitute the sole property of Pinnacle Yoga and Retreat Center, LLC, with full right of disposition in any manner whatsoever, including the right to publish on the web or in print.


9. By watching videos (live stream or recorded) from Pinnacle Yoga and Retreat Center, LLC, I am agreeing to all the liability releases above for in person classes. 


10. I understand that if I am taking hot yoga, the room will be heated, in some circumstances, up to 105 degrees F. This can be strenuous and aggravate a physical or medical condition. Before participating in any exercise in the heated room, it is advised to consult your doctor as to your fitness to participate in the activity.


11. I understand and agree that the company is not responsible for property that is lost, stolen, or damaged while in, on, or about the premises.


12. I agree to adhere to any and all current covid-19 protocol set forth by Pinnacle Yoga and Retreat Center and the state of New York while on the premises.


Thanks for submitting!

bottom of page