Wendy Shubin is not a licensed physician. Although she is a licensed medical provider as a Certified Physician Assistant, she is not acting as a Certified Physician Assistant. She is not diagnosing, prescribing, treating or curing any medical condition.
In consideration of the Yoga Therapy instruction and classes, ELDOA™ instruction and classes, related physical fitness services to be provided to me by Wendy Shubin individually, (collectively the “Activity”), intending to be legally bound and hereby and on behalf of myself and my heirs and personal representatives, I expressly agree to:
Ascertain whether I have any health condition, which makes it inadvisable for me to participate in the Activity and I acknowledge the risks and hazards associated with my participation in the Activity;
Abide by the rules and regulations governing the Activity as determined by Wendy Shubin;
I understand that Wendy Shubin is instructing me in a deepening towards the understanding of Yoga Therapy, ELDOA™, and related physical fitness services, (collectively the “Activity”);
The services provided during the “Activity” are not licensed by the state of California.
I understand the nature of our interaction will be purely educational in the realms of the “Activity”. Under no circumstances is this interaction meant to diagnose or treat a medical condition in the U.S., in the world and in the universe. Wendy Shubin is no way to be held accountable or liable for any direct or indirect advice given to me. She may be able to help me understand concepts pertinent to health management and prevention and may recommend various things for me to consider in management of health and in the realms the “Activity;”
I understand she may assist me in learning a yoga therapy, ELDOA™, and physical fitness approach to managing diseases that are under an individual’s control;
I certify that I am not seeking the counsel of Wendy Shubin to treat a physical infirmity or chronic ailment or injury, nor am I using her advice to diagnose or treat disease in others, but that I am consulting with her to learn about strengthening and managing general health, so as to better educate myself. I agree that I (or heirs, guardian, legal representative and assigns) will not make a claim or file an action against her for injury or damage resulting from negligence or other acts, howsoever caused in connection with my education in the “Activity” with Wendy Shubin. I also hereby waive, release and discharge Wendy Shubin from all actions, claims or demands that I, my heirs, guardians, legal representatives or assigns, no have or may hereafter have for injury or damages resulting from participation in consultations with her. I have read the above release and waiver of liability and understand its contents. I agree to the terms and conditions stated above.
I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE Wendy Shubin or coporatate entity with which she is associated belong, for which (hereinafter referred to as RELEASEES) from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, while participating in the Activity, while in, on or upon the premises where the Activity are being conducted, REGARDLESS OF WHETHER SUCH LOSS IS CAUSED BY THE NEGLIGENCE OF THE RELEASEES, or otherwise and regardless of whether such liability arises in tort, contract, strict liability, or otherwise, to the fullest extent allowed by law.
I further hereby AGREE TO INDEMNIFY AND HOLD HARMLESS the RELEASEES from any loss, liability, damage, or costs, including court costs and attorneys’ fees that Releases may incur due to my participation in the Activity, WHETHER CAUSED BY NEGLIGENCE OF RELEASEES or otherwise, to the fullest extent allowed by law.
It is my express intent that this Waiver and Hold Harmless Agreement shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and personal representative, if I am deceased, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named RELEASEES. Any portion of this document deemed unlawful or unenforceable is severable and shall be stricken without any effect on the enforceability of the remaining provisions.
Click here to download your copy of the RELEASE OF LIABILITY AND HOLD HARMLESS AGREEMENT for you records.