Please read the following carefully:
I, ____________________________ (client name), understand the novel coronavirus causes the disease known as COVID-19. I understand that the novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. I further understand that COVID-19 is extremely contagious and is believed to spread by person-to-person contact; as a result, federal and state health agencies recommend social distancing and physical distancing of at least 6 feet. I understand the novel coronavirus has a long incubation period, during which carriers of the virus may not show symptoms and still be contagious.
I recognize that Younique Yoga, and their instructors, are closely monitoring the situation and have put in place preventative measures aimed at reducing the spread of COVID-19. I agree to follow all protocols put in place by Younique Yoga to protect clients and staff from risk of infection. These include, but are not limited to:
• Daily staff and client COVID-19 pre screening protocol upon entering the studio/outdoor space
• Must register online for classes. Must cancel 5 hours before class or you will be charged.
• No walk ins allowed
• 6 feet social distancing
• You may not enter the studio if you are not wearing a mask. Masks to be worn at all times
• Hand sanitation upon entering and exiting
• Hand sanitation after using the restroom
• All studios will have limited space for 6ft distancing
Given the nature of the virus, I understand that there is an inherent risk of becoming infected with COVID-19 by entering this establishment, for all classes at Younique Yoga I am attending. I understand that the CDC has asked individuals to maintain physical distancing of at least 6 feet.
I verify that I have not been identified as a close contact of a confirmed case of someone who has tested positive for novel coronavirus and/or been asked to self-isolate by any governmental health agency. I confirm that to my knowledge I do not have any symptoms, I am not currently positive for the novel coronavirus, and that I am not waiting for results of a laboratory test for the novel coronavirus.
I understand that any international travel, including travel by car, air, bus, boat or train, significantly increases my risk of contracting and transmitting the novel coronavirus. The CDC requires self-isolation for 14 days from the date a person has returned to America. I verify that I have not left the country, whether by car, air, bus or train, in the past 14 days.
By signing this form, you acknowledge that you are entering at your own risk and YOUnique Yoga and its independent contractors are not responsible for any injuries resulting from your participation in any activities at our facilities.
. All Session packages expire in 6 months from date of purchase.
Younique will be reopening on August 15. All valid packages as of March 15th when we had to close will be extend upon reopening. If you are an existing student signing up through Karmasoft link please email us through our website to transfer any new classes into your new account.
Print Name: __________________________________________ Date: ___________________
Signature: ____________________________________________Date: __________________
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