Kids Yoga Summer Camp Registration AGES 6-9 Parent First/Last Name * Parent Email * Parent Phone Number * Child Name * Additional Children Names (if applicable) Has your child ever done yoga before? * Yes No Does your child have any medical alerts or allergies? * If so, please specify Are you an Eclipse Power Yoga Member? * If yes, your card on file will be charged to reserve your spot for Kids Yoga Summer Camp Yes No How will your child be getting home? * Release & Waiver of Liability * I, hereby agree to the terms and conditions set forth in this Liability Waiver in consideration for being allowed to participate in the kids yoga classes offered by Eclipse Power Yoga. Assumption of Risk: I understand and acknowledge that participating in yoga classes involves inherent risks, including but not limited to, physical injury, illness, and emotional distress. I voluntarily assume all risks associated with my participation, including those that may arise from the negligence or carelessness of Eclipse Power Yoga, its instructors, or other participants. Physical Health and Ability: I certify that I am physically fit and able to participate in the kids yoga classes offered by Eclipse Power Yoga. I acknowledge that it is my responsibility to consult with a physician prior to participating if I have any concerns about my physical health or ability to participate safely. Parental Consent: As the parent or legal guardian of the participant, I give my consent for them to participate in the kids yoga classes. I understand and acknowledge the risks involved and agree to assume all responsibility for their participation. Release of Liability: I hereby release, waive, discharge, and covenant not to sue Eclipse Power Yoga, its owners, instructors, employees, and agents from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including but not limited to personal injury, disability, death, or property damage, that may be sustained by me or the participant while participating in the kids yoga classes, whether caused by the negligence of the released parties or otherwise. Indemnification: I agree to indemnify, defend, and hold harmless Eclipse Power Yoga, its owners, instructors, employees, and agents from and against any and all liability, claims, damages, losses, costs, or expenses, including legal fees, arising out of or related to my participation or the participation of the participant in the kids yoga classes. Photography and Video Release: I hereby grant Eclipse Power Yoga the right to take photographs and videos of me or the participant during the kids yoga classes and to use such photographs and videos for promotional and marketing purposes without compensation to me or the participant. Severability: If any provision of this Liability Waiver is found to be unenforceable or invalid, such provision shall be severed from the remaining provisions, which shall continue to be enforceable to the fullest extent permitted by law. I have read this Liability Waiver, fully understand its terms, and voluntarily agree to be bound by them. Agree Which Dates Would Your Child Like to Attend? 7/14 7/21 7/28 8/4 8/11 ALL DATES Thank you!
