COVID-19 PANDEMIC

WAIVER/CONSENT FORM

COVID-19 PANDEMIC WAIVER/CONSENT FORM-AYH

I understand that due to nature of this environment and the characteristics of the virus, even with safety protocols in place (cleaning/disinfecting, 6ft distancing, mask requirement, etc.), that I am at risk of contracting the virus simply by being present in the yoga studio.

I confirm that I am not presenting any of the following symptoms of COVID-19: ★ Recent/new onset coughing (not related to allergy or COPD) ★ Nasal congestion/runny nose (not related to allergies or sinus infections) ★ Recent/new onset sore throat/dry cough ★ Recent/new onset shortness of breath (not related to chronic disease) ★ Recent/new onset diarrhea ★ Recent/new onset of loss of taste/smell ★ Recent/new onset of nausea/vomiting ★ Recent/new onset of fatigue/malaise

I understand that air travel significantly increases my risk of contracting and transmitting the COVID-19 virus. In the last 14 days: ★ I verify that I have not travelled via airline, bus, or train ★ I verify that I have not stayed overnight in housing that is not well known to me (i.e. hotel)

I confirm: ★ I have not been in contact with an individual positive for COVID-19 ★ I am not living with someone who is quarantined

In the case that I have tested positive for COVID-19, I confirm: ★ I have received a COVID-19 negative test and physician clearance out of quarantine ★ I have been under the care of a physician and have been cleared for physical activity

Although there are no guarantees in regard to the possibility of contracting COVID-19, AYH/MMM and its teachers will be following safety protocols as to best protect myself and themselves during teaching sessions.