Therapeutic Yoga Consent and Waiver Form

Therapeutic Yoga Consent and Waiver Form

We’re so excited to have you and/or your child/young person join our yoga classes! Before we roll out the mats, we just need a few details to keep everyone safe. Please complete the sections relevant to your yoga class below:
Participant Details
Child's Full Name

First NameLast Name
Child's Date of Birth
Parent/Guardian Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Name

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Health and Safety
Yoga is fun and safe, but it’s still exercise. Sometimes muscles might get a little sore, or a pose might feel tricky.

Please tell us if your child/young person has:

Any health conditions, injuries, physical disabilities or allergies:

Please tell us if you have:

Any health conditions, injuries, physical disabilities or allergies:

We trust that you and your child are healthy enough for gentle yoga, and we’ll always offer ways to modify poses if needed.
Consent to Participate
I give permission for myself and/or my child to join in the yoga classes. I understand:

We can stop or take a break anytime.
We are in control of our own bodies, and we can make choices in accordance with our own needs.
The teacher will help everyone move safely and may suggest more appropriate variations of poses to keep all bodies safe.
Waiver & Release
While we take care to make yoga safe and fun, accidents can happen. By signing, I agree that Lemon Drops Kids Therapy and its teachers are not responsible for injuries, except in cases of gross negligence.
I’ve read this form, understand it, and agree with the above.
Name

First NameLast Name
Signature
Date

MonthDayYear
Date
Should be Empty:

Therapeutic Yoga Consent and Waiver Form

Emergency Contact

Health and Safety

Consent to Participate

Waiver & Release