Name *

First Name

Last Name

Participation In 2026 Cohort *

200-Hour Foundational Teacher Training Student

300-Hour Advanced Teacher Training Student

Mentor

Phone *

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Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name *

First Name

Last Name

Phone *

(###)

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Dietary Preferences

Please let us know about your dietary preferences.

Vegetarian

Vegan

Gluten Free

Grain Free

Dairy Free

Raw Food Only

Mentor & Peer Groups *

Mentor and peer groups meet once a month September through April. Please choose your preferred mentor and peer group meeting date and time. Please refer to the year-at-a-glance calendar for exact dates.

Monday Mentor & Peer Groups (10:00am-11:30am)

Tuesday Mentor & Peer Groups (6:30pm-8:00pm)

Thursday Mentor & Peer Groups (6:30pm-8:00pm)

Sunday Mentor & Peer Groups (11:00am-12:30pm)

Slack App *

In addition to e-mail, we will be using the Slack platform to facilitate group communication during yoga teacher training. Slack is a chat-based collaboration tool designed to facilitate group communication. Please download the Slack App now and join the #2026Cohort thread. Thank you!

I have download the Slack App and am ready to roll with group communications related to yoga teacher training!

Express Assumption of Risk *

Please read this express assumption of risk provision and mark the circle to indicate your understanding and acceptance.

I recognize there are physical, mental, and emotional risks involved with participating in Community Yoga Center's yoga teacher trainings, courses, events, and activities (collectively "Activities"). I understand that I am choosing to participate in the Activities and it's my responsibility to take care when determining my ability to participate in the Activities. If I have any concerns whether the Activities are suitable for me or if I have a particular condition that may impact my ability to participate in the Activities, I agree to seek medical advice prior to participating in the Activities. I acknowledge the health risks associated with the Activities, including but not limited to dizziness, lightheadedness, fainting, nausea, muscle cramping, musculoskeletal injury, heart attack, and stroke. I agree that if I experience any symptoms of this nature during the Activities, I will discontinue participation in the Activities immediately and seek appropriate medical attention. Participation in the Activities includes the potential risk of death and exposure to infectious diseases. I knowingly and freely assume all such risks and agree to participate in the Activities with knowledge of the danger involved. I expressly agree to assume all risks of participation.

Health Representations *

Please read these health representations and mark the circle to indicate your understanding and acceptance.

I represent that I am in good health, and suffer no physical, mental, or emotional impairments, injuries, or illnesses that will endanger me or others while participating in the Activities.

Consent To Receive Medical Treatment *

Please read this consent to receive medical treatment and mark the circle to indicate your understanding and acceptance.

I understand that on rare occasions an emergency requiring medical treatment can develop. I consent to receive medical treatment that may be deemed advisable in the event of accident, injury, or illness during the Activities. I further agree to pay for any medical treatment rendered to me. It is understood that efforts shall be made to contact my designated emergency contact before rendering treatment, but that any of the above treatment will not be withheld if my designated emergency contact cannot be reached.

Release of Liability *

Please read this release of liability and mark the circle to indicate your understanding and acceptance.

I acknowledge that I derive personal benefit from my participation in the Activities, and in consideration for the same, I release, waive, and forever discharge Community Yoga Center, Inga Buchbinder, Allison Hagen Kennedy, Tobias Moyneur, Cherie Robinson, and Kristin Varner, and their principals, agents, employees, volunteers, representatives, and associated third parties ("Released Parties") from any and all present and future liabilities, claims, and demands of whatever nature either in law or equity, to the fullest extent permissible by law, including but not limited to damages caused by the negligence, fault, or conduct of any kind on the part of the Released Parties, including but not limited to death, bodily injury, illness, economic loss, out of pocket expenses, property damage, which I, my heirs, assignees, next of kin, legally appointed or designated representatives, may have or which may hereinafter arise from my participation in the Activities. I acknowledge that any emergency treatment I receive shall not cause and liability for the payment of such treatment to be assessed to the Released Parties. I hereby release and forever discharge the Released Parties from any claim whatsoever which arises or may hereinafter arise due to any medical treatment or service rendered in connection with my participation in the Activities.

Indemnification *

Please read this indemnity provision and mark the circle to indicate your understanding and acceptance.

I have read and understood the foregoing express assumption of risk, health representations, consent to receive medical treatment, and release of liability, and I expressly agree to indemnify and hold harmless the Released Parties for all claims arising out of my participation in the Activities, without limitation.

Permission to Use Image, Name & Voice

Please read this provision granting permission to use image, name, and voice, and mark the circle to indicate your understanding and acceptance.

I hereby grant to the Released Parties the absolute and irrevocable right and permission to use, publish, and broadcast the use of my image, photograph, likeness, caricature, voice, and name (in it's original form or as retouched, digitized, cropped, altered, or modified in any way) derived from the Activities, for any and all purposes, including but not limited to advertising, promoting, or publicizing Community Yoga Center's programs and services, in perpetuity, in any and all media now known or hereafter devised (including without limitation on the internet).

Permission For Inclusion In Community Directory

Please read this provision granting permission for your contact information to be included in our private community directory.

I hereby grant the Released Parties permission to include my contact information (name, phone number, and email address) in a private community directory accessible only to yoga teacher training students, volunteers, mentors, and organizers.

Core Values Agreement *

CYC's core values are centered around reverence for all living creatures and the whole of nature. In Yoga Teacher Training these values serve as the foundation of our yoga education, practice, and teaching. We are committed to learn, practice, and teach yoga in ways that are compassionate to ourselves, others, our communities, and the environment. Please read these core values and mark the circle to indicate your understanding and acceptance.

NON-HARMING Honoring life itself, we aspire to cultivate a reverence for all forms of life and take care to do no harm. We aspire to learn, practice, and teach yoga in ways that do not cause harm through our thoughts, words, and actions. We will not discriminate against or show disrespect for others based on appearance, skin color, national origin, ancestry, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, socioeconomic status, age, religion, physical condition, mental health, medical condition, military service, or marital status. We will treat with respect those who have different opinions, values, and attitudes than our own. In stewardship of the environment, we will bring mindfulness to the use of the earth's resources. TRUTHFULNESS Honoring truthfulness, we aspire to learn, practice, and share yoga within the boundaries of our competence, understanding the limits of our abilities. We are committed to share what we know and, with humility, acknowledge what we don’t know. We will not misrepresent our qualifications, credentials, or expertise. We will cultivate mindful communication and bring the quality of lovingkindness and caring truthfulness to our speech. We will refrain from false speech and divisive gossip. We will hold in confidence what is explicitly told to us in confidence. NON-STEALING Honoring the ideas, creativity, and resources of others, we will not take what does not belong to us. We are committed to respecting the work and property of others. We will maintain integrity in our dealings with money and material goods. MINDFUL RELATIONS Honoring healthy relations, we aspire to avoid creating harm through the misuse of our sexuality. This includes refraining from any form of sexual harassment, innuendo, suggestive comments, or sexual advances during Yoga Teacher Training. We will not engage in activities that exploit a person’s vulnerabilities. When teaching yoga, we will not use our role as a teacher to develop a sexual relationship with a student or even to intimate that one is possible. Acknowledging the inherent power dynamics in the teacher-student relationship, we aspire to continually be aware of the position of power and influence teachers maintain in relationships to students. NON-GREED Honoring equity, we are committed to a shared responsibility for awareness of and commitment to change the inequities that exist within yoga that result in many people feeling excluded and underrepresented. We are committed to making yoga more equitable, inclusive, and accessible. Honoring awareness, we aspire to refrain from addictive behaviors that diminish awareness, including the misuse of intoxicants. If we experience any personal troubles with addiction or substance abuse, we will consult with a Community Yoga Center Board Member and seek professional help. We aspire to uphold these principles to the best of our ability for the long-term benefit of ourselves, others, our communities, and the environment. We understand and agree that significant harmful actions in these areas, including but not limited to those named, may result in expulsion from Yoga Teacher Training and/or suspension of yoga credentials.

Orientation

Our first gathering as a cohort is YTT Orientation on Saturday, September 13th from 10:00 AM - 1:00 PM at Community Yoga Center (2900 Adams Street, Suite A-20, Riverside CA 92504)!

I will be there!

I am unable to attend, but have made arrangements to meet with Kristin at another time to go over the Orientation information.