Kids Yoga Class : Beginnings Learning Center
6 Week Session 1/24-2/28/2023
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Email *
Student Name *
Parent Name *
Cell Phone of Parent *
Address *
Students Age *
Student's Date of Birth *
Any physical or developmental limitations I should know about? *
Form of Payment ($100) *
Liability Waiver

I am aware that Brenda Bobby is here to serve me by sharing knowledge of yoga and fitness as a movement specialist. I understand that this practice involves physical movement and exercise which may from time to time be strenuous, and that such practice carries some risk of injury. By my participating in classes, privates, or activities with Brenda Bobby, I agree to take full responsibility for not exceeding my limits, for selecting the appropriate level of training, and for any injury I might suffer. I acknowledge that it is my responsibility to inform the instructor immediately if an injury occurs during class. I understand that during sessions, instructors may physically adjust, assist, support students’ form, and help student to stretch, release, and activate muscles. If I do not want such physical adjustments, I will inform that instructor at each session I attend. I also acknowledge that if I do wish to receive physical adjustments. I herby waive and release any claim that I might have at any time for injury of any sort against Brenda Bobby or any person or entity in any way involved therewith, including without limitations its principals, instructors, employees, agents and representatives. I give permission to use photo / video of my training with Brenda Bobby (faces can be covered upon request).

I have carefully read, fully understand and agree to the above.  

Parent name/signature  and Date 

Any additional information you wish to provide the instructor? *
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