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* 1. Student Information

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* 2. Parent/Guardian Contact Information

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* 3. 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 child's participation. I represent and warrant that my child is in good health and physical condition and has 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. In consideration of being permitted to participate, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which might be incurred 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 my child 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: My student 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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* 4. What benefits do you most wish your child to gain from practicing yoga in the after school club?  Is there anything the instructors should know about your child?

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* 5. I understand that I will need to click on the PayPal link on the www.freedomyouthyoga.org website to pay the $120 fee for the course.  The K-1 Kids' Yoga Club will meet on Fridays from 3:15 to 3:45 pm from September 6 to December 6, 2019.  Because Freedom Youth Yoga is a nonprofit organization, ASP Club fees help provide yoga practice to less fortunate youth in Smyrna.
director@freedomyouthyoga.org  770-376-0317

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