Move Through Yoga - Student and Parent Liability Release and Media Waiver
Yoga in Schools, LLC and Move Through Yoga, 501C3 are delighted to bring before/after school enrichment programming to your school. Each of our lessons, during the 6 or 8 week cycle, is designed with the intention of safety first. Students will be moving through yoga with the proper instruction and assistance of trained
and insured yoga professionals. Students will also be focusing on breathing and being still. Each of our lessons hone in on a social-emotional skills while also building physical strength.

Please read, sign and submit both of these documents before the start of your class. If these forms are not completed, the student will not be able to participate in the Move Through Yoga program. If you have any questions or concerns, please do not hesitate to reach out to registration@movethroughyoga.org
Email address *
Student Name *
Student Grade *
Name of School *
Liability/ Hold Harmless Release: I am the parent/guardian of___________________ (print full name of child) (“My Child”). I hereby grant Yoga in Schools, LLC (“YIS”) and their subsidiary company Move Through Yoga, LLC and 501c3 (“MTY”), and their agents the absolute right and permission to use photographic portraits, pictures, digital images or videotapes of My Child, or in which My Child may be included in whole or part, or reproductions thereof in color or otherwise for any lawful purpose whatsoever, including but not limited to use in any YIS and MTY publication or on YIS and MTY websites, without payment or any other consideration.I hereby waive any right that I may have to inspect and/or approve the finished product or the copy that may be used in connection therewith, wherein My Child’s likeness appears, or the use to which it may be applied. I hereby release, discharge, and agree to indemnify and hold harmless YIS and MTY, and their agents from all claims, demands, and causes of action that I or My Child have or may have by reason of this authorization or use of My Child’s photographic portraits, pictures, digital images or videotapes, including any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said images or videotapes, or in processing tending towards the completion of the finished product, including publication on the internet, in brochures, or any other advertisements or promotional materials. I represent that I am at least eighteen (18) years of age and am fully competent to sign this Release. By clicking the “consent” box, We/I hereby certify that We/I are/am the parent(s) or guardian(s) of the above named child and do hereby give our/my consent without reservation to the foregoing on behalfof My Child. *
Media Waiver: I am the parent/guardian of ____________________________________ (print full name of child) (“My Child”). I hereby grant Yoga in Schools, LLC (“YIS”) and their subsidiary company Move Through Yoga, LLC and 501c3 (“MTY”), and their agents the absolute right and permission to use photographic portraits, pictures, digital images or videotapes of My Child, or in which My Child may be included in whole or part, or reproductions thereof in color or otherwise for any lawful purpose whatsoever, including but not limited to use in any YIS and MTY publication or on YIS and MTY websites, without payment or any other consideration.I hereby waive any right that I may have to inspect and/or approve the finished product or the copy that may be used in connection therewith, wherein My Child’s likeness appears, or the use to which it may be applied. I hereby release, discharge, and agree to indemnify and hold harmless YIS and MTY, and their agents from all claims, demands, and causes of action that I or My Child have or may have by reason of this authorization or use of My Child’s photographic portraits, pictures, digital images or videotapes, including any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said images or videotapes, or in processing tending towards the completion of the finished product, including publication on the internet, in brochures, or any other advertisements or promotional materials. I represent that I am at least eighteen (18) years of age and am fully competent to sign this Release. By clicking the “consent” box, We/I hereby certify that We/I are/am the parent(s) or guardian(s) of the above named child and do hereby give our/my consent without reservation to the foregoing on behalf of My Child. *
Digital Signature of Parent or Guardian *
Are you 18 or older? *
Preferred Contact Information (Email or Phone? Please provide that information) *
Questions and comments (Optional)
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