Agreement of Release and Waiver of Liability

This form covers all classes offered by Jen Mons of Healthy Beach Girl (Healthy Beach Girl (c) )Please fill out the following, being sure to read and initial each paragraph.

I, , hereby agree to the following:

That I am participating in Yoga Classes and Workshops offered by Healthy Beach Girl during which I receive information and instruction about healthy and safe practice. I recognize that these classes and workshops may require physical exertion, which may be strenuous and could result in physical injury, and I am fully aware of the risks ad hazards involved.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in Classes, Workshops and Therapies. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in these Classes, Workshops & Therapies. (Doctor’s release may be required for certain Programs).

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. I agree to inform my instructor/teacher of any physical limitations, physical discomfort and/or injuries before or during classes, and I take full responsibility for nondisclosure.

In further consideration of being permitted to participate in Classes, Workshops, Programs & Therapies, I knowingly, voluntarily and expressly waive any claim I may have against Healthy Beach Girl for injury or damages that I may sustain as a result of participating in this program.

Check the box below:
I agree to both statements below:

I have read the above release waiver of liability and fully understand its contents. I voluntarily agree to its contents. I voluntarily agree to the terms and conditions stated above.

I hereby grant Healthy Beach Girl/Jen Mons permission to use my likeness in photographs and/or video in any and all of its publications, including Web space, and in any and all other media, whether now known or hereafter existing, controlled by Healthy Beach Girl/Jen Mons. I will make no monetary or other claim against Healthy Beach Girl/Jenny Mons for the use of the photographs and/or video.

Healthy Lifestyle Disclaimer Terms:

The materials and content contained in this program are for general health information only and are not intended to be a substitute for professional medical recommendations, advice, diagnosis or treatment.

Healthy Beach Girl is not acting in the capacity of a doctor, licensed dietician-nutritionist, psychologist or other licensed or registered professional. Healthy Beach Girl is not providing health care, medical or nutrition therapy services and will not diagnose, treat or cure in any manner whatsoever any disease, condition or other physical or mental ailment of the human body.

Upon purchasing this program, you understand that the information received should not be seen as medical or nursing advice and is certainly not meant to take the place of you seeing or continuing to visit licensed health professionals, including your physician.  Users of this program should not rely exclusively on the information provided in this program for your own health needs. All specific medical questions about your own situation should be presented to your own health care provider.  It’s always best and recommended to consult with your doctor when contemplating or making any changes in your diet and/or lifestyle.

This guide is designed to be a practical and useful reference tool. The information is based on my personal experience as a health coach.  Healthy Beach Girl makes no warranties or representations, express or implied, as to the accuracy or completeness, timeliness or usefulness of any opinions, advice, services or other information contained or referenced in this program.

** Please note that you are also agreeing to the following:

In addition, in consideration for your use of and access to this program, you agree to not sell, share or exchange this program. Please send other interested potential client to contact me at so that I may guide clients during their program.

You cannot publish all or part of the information in this program as an e-book or downloadable permission.

This information is copyrighted by Healthy Beach Girl and access to information is given to clients by Healthy Beach Girl.

Digital Signature of Participant:

Date: (hover over and click the down arrow to choose todays date.)
Email Address:   

Phone #:

Have you been approved by a doctor to exercise? YesNo

If no please get doctors approval prior to practicing.

Referred By: