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Kids Yoga Liability and Medical Waiver

Studio Name: Kathy Brown Wellness/TheYogiRD  Program: Seasonal Stories Yoga Class

Participant's Date of Birth
Month
Day
Year

1. Assumption of Risk

I, the undersigned parent or legal guardian of the participant named above, acknowledge that participation in any yoga or physical fitness activity, including those offered in the Seasonal Stories Yoga Class, involves a risk of injury, including minor, serious, or catastrophic injuries, or death.

I understand that the practice of yoga may involve dynamic movements, stretching, balancing, and relaxation techniques. I certify that my child is physically able to participate in yoga classes and that I have informed the instructor, in writing, of any current injuries, illnesses, physical limitations, or medical conditions.

I voluntarily assume all risks, hazards, and dangers associated with my child’s participation in the class, even if caused by the negligence of the instructor or staff.

2. Release and Waiver of Liability

In consideration of the participant being permitted to enroll in and attend the Seasonal Stories Yoga Class, I hereby agree to the following:

I, for myself, my child, and our respective heirs, executors, administrators, and assigns, waive, release, and discharge [Kathy Brown Wellness/TheYogiRD], its owners, instructors, employees, agents, and representatives (collectively, the "Released Parties") from any and all claims, demands, liabilities, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant or any property belonging to the participant, while participating in the program, or while on or near the premises where the program is being conducted. This release includes any claims based on the negligence of the Released Parties.

3. Indemnification

I agree to indemnify and hold harmless the Released Parties from any loss, liability, damage, or cost, including attorney’s fees, that may incur due to my child’s participation in the class, whether caused by the negligence of the participant or otherwise.

4. Medical Treatment Authorization

In the event of an injury or illness that requires immediate medical attention, and if I or the designated emergency contact cannot be reached, I hereby authorize the instructor or staff of [Kathy Brown Wellness/TheYogiRD] to seek and consent to necessary medical care for my child, including first aid, transportation to a medical facility, and treatment by licensed medical personnel. I agree to be responsible for any and all costs associated with such medical care and transportation.


Emergency Contact 1:

Emergency Contact 2

5. Photo/Media Release (Optional)

I grant permission for [Kathy Brown Wellness/TheYogiRD] to use photographs, video recordings, or likenesses of the participant for use in educational, promotional, or advertising materials, without compensation or prior notice.

Choose one
I GRANT PERMISSION for the use of my child's likeness.
I DO NOT GRANT PERMISSION for the use of my child's likeness.

6. Acknowledgment and Signature

I represent that I am the parent or legal guardian of the participant named above and have the legal authority to sign this Waiver. I have read and fully understand the terms of this Liability and Medical Waiver, and I agree to be bound by its terms.

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