During special events and workshops, photos of the event may be posted online on various social media platforms.

Please fill out the form below to give us permission to use your photographs.

If you do not wish have your photo taken, please advise your instructor in advance.
Thank you.
Empower Yoga

Event Waiver Photo Release

**Under age 18 form must be filled out by Parent/Guardian


Empower Yoga, LLC
801 Woodbury Rd Suite 100
Orlando, FL 32828

Permission to Use Photograph

I grant to Empower Yoga, LLC its representatives and employees the right to take photographs of me and my property in connection with the above-identified subject.
I authorize Empower Yoga, LLC its assigns and transferees to copyright, use and publish the same in print and/or electronically.
I agree that Empower Yoga, LLC may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.

Agreement of Release and Waiver of Liability

1. I understand that I am participating in the Yoga classes, Health Programs, or Workshops offered by Empower Yoga, LLC during which I will receive information and instruction about yoga and health. I recognize that yoga requires physical exertion which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Yoga classes, Health Programs or Workshops. I represent and warrant that I am physically fit and I have no medical condition which would prevent my full participation in the Yoga classes, Health Programs, or Workshops.
3. In consideration of being permitted to participate in the Yoga classes, Health Programs or Workshops, 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 program.
4. In further consideration of being permitted to participate in the Yoga classes, Health Programs and Workshops, I knowingly, voluntarily and expressly waive any claim I may have against Empower Yoga, LLC for injury or damages that I may sustain as a result of participating in the program.
5. I, my heirs, or legal representatives’ forever release, waive, discharge and covenant not to sue Empower Yoga, LLC for any injury or death caused by their negligence or other acts.
6. I agree to assume all responsibility for any legal fees incurred by the Participant connected with my activities and participation at Empower Yoga, LLC.

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 have agreed to submit this waiver by electronic means and I understand that an electronic signature is the same as a written signature.

Digital Signature of Participant (or Parent/Guardian if under age 18)

By typing my full name, and pressing the Send button, I am electronically signing my waiver.

*First Name

*Last Name


*Phone Number:

How did you hear about us?

*Today’s Date: Enter date as yyyy-mm-dd if auto calendar is missing.

*Please type below the name of the event and check box below then press "Send"

I agree to sign this waiver electronically

Privacy Policy:
Your privacy is very important to us.
Any personal information you choose to give us will only be used to help us provide you with the highest quality services, products, and support.
We will never share your personal information with any other party.