Liability and Consent Form for Mommy and Me: Bloom and Bond

Liability and Consent Form for Mommy and Me: Bloom and Bond

Please review and sign to acknowledge responsibility and consent for participation.
Mom's Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Child's Full Name*

First NameLast Name
Child's Age*
Please read and acknowledge the following:
Mommy & Me Yoga + Mini Flower Bouquet Bar: Participation Agreement

I understand that joining the Mommy and Me Yoga Class and the Mini Flower Bouquet Bar is completely voluntary, and I take full responsibility for myself and my child during all activities. I also understand that I am responsible for supervising my child at all times.

I release Amanda Hinkhouse and The Nook: A Therapeutic Collective from any liability for injury, loss, or damage that may happen while participating.

Refunds are available until May 2, 2026. After this date, registrations are non-refundable.
Yes, I agree.
Signature*

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Today's Date*

MonthDayYear
Date

My Products

Mommy & Me: Bloom & Bond

May 9, 2026 | 10:30AM - 12PM

$55.00

Subtotal

$0.00

Tax

$0.00

Total

$0.00