yogees class registration and release
registration and release for all public and after school classes by yogees yoga 4 kids
Email address *
Child's Name *
Your answer
Age *
Your answer
Parent Name *
Your answer
Phone number *
Your answer
Address *
Your answer
Special Diagnoses *
Allergies *
Your answer
Session requested *
Time Requested *
Your answer
I hereby give permission for my child *
CHILD WAIVER (to be signed by parent)I, the undersigned parent or guardian, understand that Yoga is not a substitute for medical attention, examination, diagnosis or treatment. In the case where my child has an injury, illness or anything else that may be affected by physical activity, I have consulted with a physician that my child can take a yoga class. I recognize that it is my responsibility to notify the instructor of any serious illness or injury before every yoga class. In further consideration of permitting my child to participate in the yoga class, I knowingly, voluntarily and expressly waive any claim I may have against Taylor Yoss and the owner/lessor of the Premises for injury or damages that my child may sustain while on the Premises as a result of participating in the yoga class. I, my heirs or legal representatives irrevocably covenant not to sue and forever release, waive, and discharge any other claims of any kind whatsoever against Yogees Yoga 4 Kids, Taylor Seideman, Heather Hopper, or any yogees yoga 4 kids contractor, or the owner/lessor of the Premises for any personal injury, property loss or damage, or wrongful death, whether caused by negligence or otherwise. I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above. I accept that neither the instructor, nor the hosting facility is liable for any injury, or damages, to person or property, resulting from the taking of the class. This form must be signed by a parent or guardian. E-signature by providing full name, below.
Your answer
A copy of your responses will be emailed to the address you provided.
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