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| Please indicate dietary needs. The food will be vegetarian. |
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| Please provide the name and phone number of the person we should contact in case of emergency. |
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| Is there anything that would prevent you from participating without putting you or others at risk during this program? This may include any physical limitations, injuries, relevant surgeries, past or present mental health issues, PTSD, substance abuse, medications or other. Enter "none" if you have no known issues. |
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| If you do not indicate their full name, they will not receive credit or receive associated promotions. |
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| Please read the Responsibility & Liability Agreement and the Protected Materials Agreement here |
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| Item 7 from waiver: I understand that Amrit Yoga Institute or its designated representative may be recording and/or photographing during this program. Unless I specify otherwise, I hereby consent to being photographed or recorded and further consent to Amrit Yoga Institute and Yoga Network International, Inc. making use of such videotapes, photographs, or segments thereof for any purpose whatsoever without the payment of any royalties or other compensation to me. I assign irrevocably to Amrit Yoga Institute and Yoga Network International, Inc. any copyright or other intellectual property that may relate to my inclusion in video, audio, or still photography footage and acknowledge that Amrit Yoga Institute and Yoga Network International, Inc. are the exclusive owners of the copyright and all other intellectual property rights to any footage in which my likeness or voice may appear. |
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| It is required by Yoga Alliance that we receive "“Explicit and Informed Consent” which is narrowly defined as overt permission for a specific Teacher to use hands-on contact that has been granted by the Student. This permission can be given verbally, in writing, by an unambiguous gesture, or via a consent indicator. Silence or lack of resistance, in and of itself, does not demonstrate consent." |
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| Double check that this is accurate! If you make an error here, your certificate will be printed exactly as it is written in this field. |
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| Please read the Canterbury Hotel Policies |
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| Please read the Programs at Canterbury Cancellation Policy here |
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| Please read the COVID-19 Programs at Canterbury Assumption of the Risk and Waiver of Liability here |
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| Please read the Programs at Canterbury Planning Your Visit Document here |
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