I, , the undersigned, hereby agree to receive Vibrational Sound healing, Yoga, and Breathwork Services provided by Soukhyam Yoga. I understand that the practitioner will use gentle sound and vibration during the sessions around and on my body. This may combine additional modalities of care as appropriate and agreed upon by the client, including but not limited to Yoga movement, breathwork, and meditation. The use of props, candle lights, aromatherapy, herbal teas, crystals, and salts will be utilized as appropriate to the session.

I Acknowledge That:

• I have provided information to the best of my knowledge.

• The practitioner is not responsible for diagnosing any illness, disease, or physical/mental disorder, nor do they prescribe any medical treatments or pharmaceuticals.

• These sessions are not a substitute for medical examination or diagnosis, and I should seek services from a primary health care provider for such needs.

Confidentiality:

Information about my sessions will not be shared with any third party without my written consent or the consent of my parent/guardian if I am under 18 years of age.

Services Covered:

Vibrational Sound Therapy, Yoga (including aerial/suspension), and Breathwork are complementary wellness practices that support the body’s natural ability to relax and self-heal. These sessions are not a substitute for licensed medical care, diagnosis, or treatment.

Touch & Participation

Gentle physical contact or hands-on adjustments may be used unless you state otherwise before the session. You are responsible for listening to your body and resting as needed.

Release of Liability, Waiver & Assumption of Risk

I confirm that I am in good physical, mental, and emotional health and do not have, or have obtained written medical clearance for, conditions such as cardiovascular disease, high blood pressure, glaucoma, retinal detachment, osteoporosis, seizure disorders, mental illness, recent injuries or surgeries, or pregnancy. I accept full responsibility for consulting my physician about my fitness to participate.

I understand that breathwork, yoga (including aerial/suspension), sound therapy, and related activities involve inherent risks—such as muscle strain, falls, equipment failure, emotional release, or rare but serious injury or death—even when all guidance is followed. I voluntarily and knowingly assume all such risks, both known and unknown, including potential exposure to contagious diseases such as COVID-19.

I understand that Soukhyam Yoga, Tanvi Patil, and their contractors are not physicians or mental-health providers and do not diagnose, treat, or prescribe. I agree to follow all instructions, respect my body’s limits, and immediately stop or seek help if I notice any unusual hazard.

I, and anyone acting on my behalf, release, indemnify, and hold harmless Soukhyam Yoga, its owner, staff, contractors, agents, and representatives from any and all claims, damages, or liabilities for injury, illness, death, or property loss arising from participation—including those due to ordinary negligence—to the fullest extent permitted by law, except in cases of gross negligence or willful misconduct.

Any dispute will be settled exclusively by binding arbitration before the American Arbitration Association in Virginia, under its Commercial Rules, with the initiating party responsible for arbitration fees and the prevailing party entitled to reasonable attorney’s fees and costs. This agreement is governed by Virginia law.

Risks & Assumption of Risk

Participation may involve physical, mental, or emotional risk—including but not limited to muscle strain, falls, dizziness, or rare serious events.

Aerial/suspension yoga involves practicing yoga postures and strength work while partially or fully supported by fabric/hammock. This carries added risks of falling or equipment malfunction.

You knowingly and freely assume all such risks, including potential exposure to infectious diseases (e.g., COVID-19).

Release & Indemnification

In consideration of participation, you (and any representatives, heirs, or assigns) release and hold harmless Soukhyam Yoga, Tanvi Patil, and any contractors or team members from any and all claims, demands, or liability for injury, loss, or damage—except in cases of gross negligence or intentional misconduct.

You agree to indemnify and defend Soukhyam Yoga and its representatives from any costs, claims, or attorney’s fees arising from your participation

Confidentiality & Intellectual Property

Personal information and session experiences are kept confidential except as required by law.

All session materials, recordings, and creative works remain the intellectual property of Soukhyam Yoga and may not be reproduced without written consent.

Dispute Resolution & Governing Law

Any dispute will first be addressed through mediation and, if needed, binding arbitration in Virginia under Virginia law.

Acknowledgment

By signing below, I confirm that I have read, understood, and voluntarily accept all terms and risks outlined in this Release of Liability, Waiver, and Assumption of Risk.

Client / Guardian or Parent (if < 18 years age) Signature: