Contact and Waiver/Release Form
Yoga is a wonderful practice with movement, breath, meditation and relaxation. As with any other exercise program I understand that it involves a certain risks of physical injury. I certify that neither my child nor myself have any known medical or other conditions that could interfere with our, or each of our individual, participation in Let it Shine Yoga's activities. Therefore, I, individually and on behalf of my child listed below, hereby release, discharge, and hold harmless Let it Shine Yoga (Marcia LeBlanc) and each of its respective parent, member, subsidiary, and affiliated companies, and each of their respective officers, directors, agents, representatives, employees, contractors, successors, assignees, and licensees (hereinafter, "the Released Parties") from any and all claims, actions, damages, losses, liabilities, costs and expenses of any kind whatsoever, including but not limited to any claims of negligence, arising out of, resulting from, by reason of, or in connection with my and/or my child's participation in any Let it Shine Yoga's programs or activities. I agree that I will not bring or be a party to any legal action or claim against the Released Parties, or any of them, based upon or arising out of my and/or my child's participation in any Let it Shine Yoga program or activity on any legal theory whatsoever (including, without limitation personal injury, negligence, rights of privacy and publicity, or defamation).

Let it Shine Yoga and its agents reserve the right to take and utilize photographs, video, or any type of recording of participating children and their parents, caregivers, or anyone accompanying them to Let it Shine Yoga while engaged in our classes or associated activities. I consent to Let it Shine Yoga's use of any photograph, video, or recording of my child, me, or the guardian I have designated for trainings, advertising, promotional, or related purposes, and waive all rights to compensation and other rights which may arise as a result.

Copyright Notice and Conditions of Use: I acknowledge that the printed materials presented in the training provided by Let it Shine Yoga are for my personal use. The printed materials cannot be used by me for training other teachers or be sold, published in print or electronically without the prior consent and acknowledgement of Marcia LeBlanc (Let it Shine Yoga)
Email *
Full name *
Child's Name (for zoom children's classes)
Age of child
Does your child have any medical concerns, injuries or anything else we should know about?
Any special interests or comments you would like to share?
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