Yoga for Kids Registration

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Parent Full Name *

Email Id *

Phone Number *

Address

City *

State *

Zip *

How did you come to know about us? *

If Friend, Thanks to:

Location *

Full Name Child 1 *

Age Child 1 *

Allergies or medical condition <br> (describe in detail) <br> (or else enter NA) *

Full Name Child 2

Age Child 2

Allergies or medical condition <br> (describe in detail) <br>(or else enter NA)

Are kids attending any Sunday School, Balavihar or Balagokulam?

Emergency Contact Name *

Emergency Contact Number 1 *

Emergency Contact Name 2

Emergency Contact Number 2

Informed Consent and Release of Liability

1. In consideration of being allowed to participate in the activities of yoga and associated exercises (asanas) conducted by Yoga Bharati and to use its rented facilities and equipment in addition to the payment of any fee or charge, I do hereby waive, release, and forever discharge Yoga Bharati, its instructors, volunteers, representatives and contractors from any and all responsibilities or liability from injuries or damages resulting from my participation. I also do hereby waive, release, and forever discharge the premises (where yoga is conducted), its trustees, and employees, representatives from any and all responsibilities or liability from injuries or damages resulting from my participation in any activities or my use of the facilities.

2. I understand and am aware that strength, flexibility, yoga, and other exercises are a potentially hazardous activity. I also understand that yoga and fitness activities involve a risk of injury and even death, and that I am voluntarily participating in these activities with knowledge of risks and dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or death. This waiver is also binding on all my heirs, executors, and others acting on my behalf.

3. I do hereby further declare myself to be physically sound and suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation in a fitness/yoga programs. I understand that it is my responsibility to consult with my physician prior to initiating any fitness/yoga program. I also understand it is my responsibility to consult with my physician about all health-related changes that may result from my exercise/yoga program. I understand that certain physiological changes are associated with exercise and yoga, some of which can pose health risks. I acknowledge that I have either had a physical examination and been given my physician’s permission to participate or that I have decided to participate in activities and use equipment without the approval of my physician and do hereby assume all responsibility for my participation in my activities. I understand it is my responsibility to notify my instructor(s) of all-physical conditions, injuries, and illnesses.

yogabharati.org

Yoga for Kids Registration