Mindfulness Program Permission Slip
OmKids, LLC
https://omkidsmaine.org
Contact us at 646-265-5201 or lee@omkidsmaine.org
Our school is partnering with a mindfulness program for part of this school year! The children will be learning how to relax their bodies, calm their minds, build self awareness and compassion. Here is what the program will look like...
1. In the classroom: Children will receive 4 mindfulness classes where they will learn how to anchor their attention, build self awareness and compassion.
2. Videos: Teachers will have access to a video curriculum that will be used in the classroom throughout the school year.
3. Workbooks: Children will have workbooks to share what they have learned with you.
School Name *
Your answer
Student Name: *
Your answer
Legal Guardian Name: *
Your answer
I, the individual named as “Legal Guardian” above, am a parent or legal guardian of the child named above as “Student.” I understand that Student’s school has arranged for OmKids LLC, to provide Student and other students with instruction related to mindfulness and compassion (all services collectively, the “OmKids Program”) at no cost to Student or to Student’s family. I understand that the OmKids Course includes in-person instruction from OmKids employees and independent contractors as well as access to and viewing of video course curriculum developed by a third-party partner of OmKids.

By signing this document, I give the Student permission to participate in the OmKids Course.

I have read and agree to the OmKids LLC Release & Liability Waiver *
Required
Date: *
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