Laughing Yoga Participation Forms - Hayley's Rose Retreat

Please ensure that you have completed both forms – Photo Consent and Liability Release Form

Photo Consent

Please read and sign this form prior to your first sessions with Hayley’s Rose Retreat.

It is intended that the photos and/or videos taken from today onwards will be used as part of publicity for any training programmes by Hayley’s Rose Retreat, seen via the website of Hayley’s Rose Retreat, on Hayley’s Rose Retreat social media platforms, Printed publications, newspapers, newsletters or exhibition packs.

I give consent to the usage above *YesNo

Participant Name *

Confirmation *

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE

Signature *

Start signing your signature here

Date *

Terms and Conditions *

Yes, I agree with the terms and conditions below.

Terms and conditions of photographic images and/or videos:

Hayley’s Rose Retreat cannot accept any liability for any loss, damage or person injury, howsoever caused, through use of the images and/or videos by third parties.
Your approval and permission shall include not only Hayley’s Rose Retreat., but Hayley’s Rose Retreat employees, agents, successors, licenses and assigns, the irrevocable right and license to use your likeness and/or voice on videotape or film, photograph or audiotape; to edit such videotape or film or audiotape or crop photographs at your discretion, to incorporate the same in the above production and to use or authorise the use of such videotape or film, audiotape of photograph or any portion thereof in any manner or media at any time in perpetuity and to use your name, likeness, voice and biographical or other information concerning you in connection therewith, including promotion in all media.
Websites can be seen globally and no warranty can be given that adequate data protection legislation will apply.
Your full name with your address details will not be supplied with photographs and/or videos. Furthermore, we will not include any personal e-mail or other personal addresses, telephones or fax numbers in association with the images.
Your image(s) and/or videos will be retained on our files. You may withdraw your consent at any time by writing to Hayley at hayleysroseretreat@gmail.com. However, you must acknowledge that images that have been used with your consent may still be in circulation and may not be withdrawn.

Hayley’s Rose Retreat is committed to the protection of your privacy, and under the Data Protection Act 1998 requires your consent to use your image(s) and/or videos in this way.

GDPR *

Yes, I agree with the below.

In order to comply with the General Data Protection Regulations, it is necessary for me to check whether or not you are happy for me to retain your contact details, and to send you information that I think may be useful to you, including training and events, and relevant updates. To ensure that I only communicate with you with the contact details you have provided me above.

I only hold information when it is necessary to do so in order for me to carry out my work. I aim to keep your photo consent until you withdraw via email to me. It gets stored in a lock box at the business address and if completed via website it gets printed out and stored in lock box at business address. It will be disposed by deletion if via website email or shredded if paper form. Your email withdrawing consent will be kept in a lock box at the home address.

Laughter Yoga Information and Liability Release Form

Please read and complete this form below before attending any Laughter Yoga

Participant's Name *

Emergency Contact Name *

Emergency Contact Number *

Do you have any allergies, chronic illness, or medical conditions? *YesNo

Please describe

Are you on a prescribed inhaler? *YesNo

Explain any instructions

Laughter yoga is a fun and healthy exercise regime with beneficial effects for the body, mind and emotions. Like any form of aerobic exercise, it should not be practiced by people with medical problems without first taking advice from their medical practitioner.

Laughter yoga should not be considered as a substitute for proper medical consultation for physical, mental and psychological illnesses.

It may not be suitable for everyone. Laughing involves some physical strain and a rise in intra- abdominal pressure. It is contraindicated for people suffering from

Advanced (bleeding) piles? *YesNo

Any kind of hernia? *YesNo

Any persistent cough? *YesNo

Anything with acute symptoms? *YesNo

Epilepsy? *YesNo

Heart disease? *YesNo

High blood pressure? *YesNo

Incontinence of urine? *YesNo

Major psychiatric disorders? *YesNo

Severe backache? *YesNo

Undergone surgery within the last 3 months? *YesNo

None of the above? *YesNo

This list is for guidance only and is not meant to be exhaustive. If in doubt, first consult a trained medical professional for guidance. Anyone already undergoing physician-prescribed therapy should seek the advice of their doctor before reducing or stopping such treatment.

Please use your common sense. If during a session you feel sudden or new pain please leave the session immediately, or advise the leader if you require assistance.

Do you have any food or drink allergies? (Cake is offered in some classes) *YesNo

Liability Release

Name *

Street Address *

Apartment, suite, etc

City

County

Postcode

Country

Please Read This Carefully:

I am participating in laughter yoga sessions requiring physical exertion that may be strenuous and may cause physical injury. I am fully aware of the risks and hazards involved.

I am physically fit and I have no medical condition that would prevent my full participation in laughter yoga sessions, or if I have any medical problems or conditions I have fully revealed these to the laughter yoga leader before each session.

I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the sessions, and knowingly, voluntarily and expressly waive any claim I may have against Hayley’s Rose Retreat, their leaders, teachers, employees or assistants for injury or damages that I may sustain as a result of travelling to, participating in or returning from a laughter yoga session. I agree that I, my heirs or legal representatives forever release waive, discharge and covenant not to sue for any injury or death caused by their negligence or other acts.

Everything above is in relation to both online and in person laughing yoga sessions.

When participating online It is compulsory that your video is on at all times and all of you can be seen by the teacher. You will make sure there is no hazards and you provide yourself suitable space to do your session. You will let the teacher know of any problems or concerns during the class. You will be able to see and hear the teacher fully who will be demonstrating and teaching your session.

Pre Recorded Classes – If you participate in a pre recorded class by Hayley’s Rose Retreat it is your responsibility to keep yourself safe and not do anything that may harm you or cause you any discomfort. You may find not all the things on the recording can be done by you and it will be for you to be aware of this and not do what you can’t. The teacher is not there to see what you are doing and so can’t take responsibility for your safety. Please keep your area clear from obstructions and only do what you are physically and mentally able to. You will still need to fill out a medical form for this so Hayley’s Rose Retreat can be sure this recording is okay for you to do.

GDPR Consent *

I only hold information when it is necessary to do so in order for me to carry out my work. I aim to keep personal data on this form whilst you are attending my classes only. It gets stored in a locked box at the business address and if completed via the website, it gets printed out and stored in a locked box at the business address. It will be disposed by deletion if via the website email or shredded if paper form.

When providing refunds as bank transfers any bank details provided to Hayley’s Rose Retreat will be used for the purposes of that refund only and deleted straight after. No bank details get saved.

Confirmation *

By acknowledging and signing I am delivering an electronic signature that will have the same effect as an original manual paper signature. The electronic signature will be equally as binding as an original manual paper signature.

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.

I understand that there is a 24 hour cancellation policy in place for any Laughing Yoga classes. When cancelling less than 24 hours will result in loss of full class payment.

Signature *

Start signing your signature here

Date *

Parent or guardian Signature

Start signing your signature here

Parent or Guardian Print Name