Janice Story LLC
Equine Assisted Coaching
Mind, Body, Spirit Practitioner
Lightening the load with The Red & Blue
Books and Card Decks
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Waiver of Liability and Disclosure
That Janice Story has informed me, and I am aware, that she is not licensed under laws of this state to practice any form of medicine and will neither diagnose nor prescribe for any condition or problem from which I may appear to be suffering.
I understand and am aware that no guarantee or promises of cures have or will be made to me and that any benefits which I experience come from within my own awareness and self-knowledge.
I understand and am aware there is an inherent risk associated with any exercise program including my voluntary participation in yoga that may result in injury. The exercises related to yoga will challenge my cardiorespiratory and musculoskeletal systems associated with: the aerobic, anaerobic, strength, power, agility, flexibility and breathing components of the program.
I certify that I am physically well and suffering from no medical problems, conditions, impairments, diseases or any other illness that would prevent my participation or increase my risk of injury and/or illness as a result of partaking in a yoga program.
I, my heirs, or legal representatives, do hereby waive and release Kate Shipp from any and all liability and responsibility from injury, accident, illness, legal and medical fees sustained now or in the future resulting from my participation in a yoga program.
I accept terms & conditions
I am 18 years of age or older or have the signature of my Legal Gaurdian below
My signature below is my true and Legal Name
If under 18 years of age. Legal Guardian's Signature
Emergency Contact Information
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