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Health Declaration

Please fill out the following health declaration form in order to participate in classes and events with Nicola Glenn Yoga. Submissions are valid up to 24 hours prior to the activity.
Please answer the following:

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liability waiver

Waiver of Liability, Nicola Glenn Yoga T/A Higher Power Arts Yoga 


 June 2023


I hereby agree to the following:


I acknowledge that I have voluntarily applied to participate in Nicola Glenn Yoga’s (T/A Higher Power Arts)  in person studio and/or  online or ‘on demand’ yoga class / workshop / ceremony / event / services. In consideration of being allowed to take part in any of these services, I agree to this release of claims, waiver of liability and assumption of risks.


By booking any services with NicolaGlenn yoga T/A Higher Power Arts, you confirm that you have read and understood our Health and Safety Declaration/waiver and read all of the Terms and Conditions of Purchase & Practice with Nicola Glenn Yoga T/A Higher Power Arts. 



I understand that Nicola Glenn Yoga T/A Higher Power Arts reserves the rights to make alteration to the timetable / teachers / equipment as well any ancillary facilities (in the private house domain) that may or may not be provided and on occasions at minimal notice. 


I understand that photos and videos may be taken of the classes and used by Nicola Glenn Yoga T/A Higher Power Arts.


I acknowledge and accept that classes may be recorded to stream on Nicola Glenn Yoga T/A Higher Power Arts’ website or other third-party platforms at a later date. By taking part in the class, I agree to my image being used as it appears in the online yoga meeting (Zoom or any other online provider used by Nicola Glenn Yoga T/A Higher Power Arts). It is my responsibility to make my image non-visible by switching-off my video camera if I do not wish to be recorded in this way. 


I acknowledge that sessions may be physically strenuous and I agree that I voluntarily participate in a session with full knowledge that even if the teacher and any other teacher involved in the session is not negligent there is an inherent risk of personal injury or illness arising from my participation in any exercise program and use of specialist equipment.


I release from liability Nicola Glenn Yoga T/A Higher Power Arts and any other assistants or employees for any personal injury, death, property damage or loss or any nature suffered by me as a result of participation in any activity in the class. I am medically, physically, emotionally and in all respects fit and able to participate in this class.  In consideration of being permitted to participate in this class I agree to assume full responsibility for any risks, injuries or damages which I might incur as a result of my participation in this class.

If I have any concerns about my fitness or health, I will seek appropriate medical advice from my GP, physiotherapist or other relevant professional medical or other adviser and obtain their written consent where necessary before attending a session. Advice provided by any member of the Nicola Glenn Yoga T/A Higher Power Arts team involved in a session at no time constitutes medical advice and is not a substitute for advice provided by a medical professional.

I confirm that I have no health or fitness problems (including, but not limited to cardiac irregularities; spinal, bone, joint, tendon or ligament injuries; spells of dizziness; asthma or other breathing difficulty; diabetes; epilepsy or other allergy) which may affect my participation in any session.


You have agreed to tell us:


Of any special physical needs, any issue relating to your health, fitness or physical limitations of which you are aware, and any medical condition or on-going medical treatment, which might be relevant to any activity to be undertaken at a session.


Of any medical condition or are taking any medication which may affect your ability to undertake any activities at a session or to use any equipment or facilities provided by us.

Of any circumstances affecting your health which may be worsened by any activities at a session.


If you are pregnant, and if so whether you are in the first 3 months of your pregnancy.


You agree not to attend any session when under the influence of alcohol or illegal drugs.


You agree: 


I understand that I may receive physical assists / adjustments to enhance or correct my body alignment during class by the teacher or teachers assistant. I will take accountability for alerting the teacher / assistant of any injury or impairment prior to the class commencing or make them aware if I do not wish to receive physical assists / adjustments.


I will faithfully follow all instructions given to me as to how to perform and not to perform any yoga poses or movements, or yogic techniques, it being understood that any deviation by me from such instructions shall be at my own risk.


I agree that I will arrive at least 10 minutes prior to the start time of a session. If I arrive later than a session start time (more than 5 minutes later) and I arrive after any warm-up for that session or services has begun, I acknowledge that any teacher at Nicola Glenn Yoga T/A Higher Power Arts may not permit me to participate in the session for health and safety reasons.


I knowingly, voluntarily and expressly waive any claim I may have against Nicola Glenn Yoga T/A Higher Power Arts or any employee or collaborator for injury or damages that I may sustain as a result of participating in the program or from receiving any of their services.


I, and my heirs or legal representatives forever release now and in the future, waive, discharge and covenant not to sue Nicola Glenn Yoga T/A Higher Power Arts, any employee, assistant, collaborator or any company within, for any injury, death caused by their negligence or other acts.


I understand that I am responsible for personal belongings during any services that I attend at 30 Leconfield Road, Lancing, BN15 9JB. I agree that Nicola Glenn Yoga T/A Higher Power Arts is not responsible for any loss / damage to any of my belongings.  I acknowledge that the personal home and contents insurance of Nicola Glenn Yoga T/A Higher Power Arts at 30 Leconfield Road, Lancing, BN15 9JB does not cover any loss or damage to my personal belongings, whilst I participate in any services offered within the outbuilding known as The Dreaming Moon at the above premises at 30 Leconfield Road, Lancing, BN15 9JB, belonging to Nicola Glenn Yoga T/A Higher Power Arts.


I have read the above release and waiver of liability carefully and fully understand the contents and this agreement with Nicola Glenn Yoga.  I voluntarily sign it, agree to the terms and conditions listed above and attend any of their services offered of my own free will.

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