1. I recognize that activities related to yoga, workshops, retreats and/or trips involve physical activities which may be strenuous and may cause injury. I understand that I must judge my own capabilities with respect to any activity. By my participation in any activity or practice taught at or by Healing Starts at Heart Center, LLC., in any location, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, that I may incur. 2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any activity. I represent and warrant that I am physically and mentally fit and have no medical condition which would prevent my full participation in any activity. I acknowledge that it is my responsibility to inform the instructor of any injury or other condition that might affect my ability to participate in any activities, and to inform the instructor immediately if an injury occurs. 3. Although I acknowledge there is no obligation for any person to provide medical care during, prior to or after any activity related to Healing Starts at Heart Center, LLC.. I hereby give permission for staff to provide first aid, administer prescribed or OTC medication as prescribed or directed by participant, and/or aid in seeking emergency medical treatment as needed. IN THE EVENT MEDICAL TREATMENT IS PROVIDED TO ME, I HEREBY WAIVE ANY CLAIM AGAINST DIANE HANES, HEALING STARTS AT HEART CENTER, LLC., THEIR OFFICERS, EMPLOYEES, SUBCONTRACTORS AND/OR AGENTS FOR ANY INJURY, DAMAGES OR DEATH CAUSED BY THE NEGLIGENT PROVISION OF SUCH MEDICAL CARE. 4. I, MY HEIRS OR REPRESENTATIVES RELEASE, WAIVE, DISCHARGE AND COVENANT NOT TO SUE OR ASSERT CLAIM AGAINST DIANE HANES, HEALING STARTS AT HEART CENTER, LLC., THEIR OFFICERS, EMPLOYEES, SUBCONTRACTORS AND/OR AGENTS FOR ANY INJURY, DAMAGES OR DEATH CAUSED BY THEIR NEGLIGENCE. I KNOWINGLY, VOLUNTARILY AND EXPRESSLY WAIVE ANY CLAIM I MAY HAVE AGAINST DIANE HANES, HEALING STARTS AT HEART CENTER, THEIR OFFICERS, EMPLOYEES, SUBCONTRACTORS AND/OR AGENTS FOR ANY INJURY, DAMAGES OR DEATH AS A RESULT OF PARTICIPATING IN HEALING STARTS AT HEART CENTER, LLC. ACTIVITIES OF ANY KIND. 5. I have carefully read this waiver and release, I understand that I have the opportunity to negotiate its terms with the owners of Healing Starts at Heart Center, LLC. By signing this form, I voluntarily agree to the above terms, releasing Healing Starts at Heart Center, LLC. from its own negligent acts.