Photo Consent and Liability Waiver

The Hasbrouck Education and Career Center

1. I am participating in classes or services during which I will receive information and instruction. I recognize that this
requires physical exertion, which may cause physical injury, and I am fully aware of the risk and hazards involved.

2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any
physical fitness program, including what The Hasbrouck Education and Career Center is holding today. I represent
and warrant that I have no medical condition that would prevent my participation in physical fitness activities.

3. In consideration of being permitted to participate in these classes, I agree to assume full responsibility and any risk,
injuries or damages, known and unknown, which I might incur as a result of participating in any program  The
Hasbrouck Education and career Center is running.

4. In further consideration of being permitted to participate in the yoga classes, workshops and/or any event I
knowingly, voluntarily, and expressly waive any claim I may have against The Hasbrouck Education and Career
Center, the instructor, the owner, or the leaseholder of any building for injuries or damages that I may sustain as a
result of participating in classes or workshops held at common ground.

5. That if I participate in other classes or events that The Hasbrouck Education and Career Center offers (such as
dance, martial arts, charity work, any event, etc.)  that I will also assume full responsibility for any injuries that may
result from my participation, with the same considerations that this waiver stipulates for yoga and other activities
(items 1-4 above).

6.) I hereby authorize The Hasbrouck Education and Career Center to use my photo and/or information related to my
experience at their classes, workshops or any event. I understand this information may be used in publications,
including electronic publications, audio visual presentations, promotional literature, advertising, community
presentations, letters to legislators and media and/or other similar ways.

7.) My consent is freely given as a public service to The Hasbrouck Education and Career Center, without payment. I
release The Hasbrouck Education and Career Center and their respective employees, officers and agents from any
and all liability which may arise from the use of such news media stories promotional materials, written articles,
videotape and/or photographs.