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* 1. Please enter the following information

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* 2. Contact information

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* 3. Please tell us how you heard about the class, and offer any insight on great places to spread the word.

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* 4. Waiver and Release Statement

I understand that this children's yoga class will include physical movements and exertion. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. I understand that it is my responsibility to consult with a physician prior to and regarding my participation. I represent and warrant that I and my child are in good health and physical condition and have no medical condition which would prevent full participation. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature below verifies that I have my physician’s approval to participate. In consideration of being permitted to participate, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program. I expressly irrevocably release and waive any claims that I have now or may have hereafter for any reason against FreedOM Youth Yoga, its owners, employees and independent contractors, for injury or damages that may be sustained as a result of participating.

I am the parent and/or guardian of the minor child/children for whom I am registering. I have read this release and permission and fully understand its contents, and I have the full right and authority to execute this release and permission.

Photos: Children and adults may be photographed during yoga classes and these photographs may appear in promotional materials unless otherwise specified. No person whose photograph is used will be identified by name, nor will any compensation be extended for such use.

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* 5. What did you (and your child) like most about the class?  What changes would make the class better?  What specific time or day of the week would work better with your child's schedule?  Share information about your child that would be helpful.  Offer any comments, questions, or concerns.

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