Student Disclaimer Form / Waiver of liability

I, __________________________________________________hereby agree to the following:

  • Yoga  is  not  a  substitute  for  medical  attention,  examination,  diagnosis or  treatment.  Yoga  is  not  recommended  and  is  not  safe  under  certain medical  conditions
  • I represent and warrant that I am physically fit and I have no medical condition, which would prevent my full participation in these yoga classes, health programmes or workshops.
  • I understand that it is my responsibility to consult a physician prior to and regarding my participation.
  • I understand that it is my responsibility to express any circumstances which will limit my practice.
  • I recognize that exercise requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
  • If I am pregnant I understand that I participate fully at my own risk and that of my unborn child/children.
  • The instructor may physically adjust students’ form and posture or give assistance. If I do not want to be touched ((any)more), I can express that wish at any moment without giving further explanation.
  • I take full and sole responsibility from any liability of loss or damage to personal property.
  • I know, due to the international scope of the activities of the instructor, that there is no liability insurance which will cover any injuries or damages.


  • I agree to assume full responsibility for any risks, injuries or damages which I might incur as a result of participating.
  • I knowingly, voluntarily, expressly and irrevocably release and waive any claim I may have against my instructor or substitute teacher for injury or damages that I may sustain as a result of participating in these programmes.

Name ______________________________________

Date _____________________


Code of conduct

I agree to uphold the following ethical principles:

  • Conduct myself in a professional and conscientious manner. This includes, but is not limited to, ensuring that I live up to any commitments I make to my students or to the public, and ensuring that my practices and behavior conform to the representations I make about myself in holding myself out as a yoga practitioner who adheres to certain precepts.
  • Acknowledge the limitations of my skills and scope of practice and where appropriate, refer students to seek alternative instruction, advice, treatment or direction.
  • Create and maintain a safe, clean and comfortable environment for the practice of yoga.
  • Encourage diversity by respecting all students regardless of age, physical limitations, race, creed, gender, ethnicity, religion or sexual orientation.
  • Respect the rights, dignity and privacy of all students.
  • Avoid words and actions that constitute sexual harassment or harassment based on other legal protected characteristics.
  • Adhere to the traditional yoga principles as written in the yamas and niyamas.
  • Follow all local government and national laws that pertain to my yoga teaching and business.


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Contact information

Owner and Data Controller : Rene Smit / YepYoga – Musselkanaal, The Netherlands
Owner contact email: click here