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               Have you attended any yoga classes?      Yes No   If Yes, Where?  

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               Maintain Physical Health            Cure Ailments              Stress Relief/Relaxation

               Peace of Mind                           Increase Spiritual Awareness

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       "I understand, acknowledge and appreciate that, as with any physical activity, there is some risk of physical injury and damage associated with my participation in yoga and I assume such risk.  I represent that I am in good health and suffer from no physical impairment.  In consideration of the privilege of participating in the yoga program sponsored by Universal Peace Foundation of North America, I hereby release, discharge and relinquish Universal Peace Foundation of North America, and its respective officers and employees, of and from all claims, demands, actions, and causes of action of any sort, for any injuries sustained in connection with my participation in the yoga program sponsored by Universal Peace Foundation of North America.

         I have read the above release and waiver of liability and fully understand its contents."