Babies' enrollment and waiver form

Enrollment and waiver - Om Babies classes

Yoga is an ancient tool for modern life and it can benefit all bodies, even little ones.
Before your child gets started on their yoga journey there are some questions I need to ask. Please take a moment to read and complete the below form, and submit at least 24 hours before your child's first class.

Please complete all fields

* Indicates required field

Parent/Guardian Name *

First

Last

Phone Number (we will always call named parent/guardian in first instance if there is an emergency) *

Baby's Name *

First

Last

Baby's Date of Birth (dd/mm/yy) *

Please detail any medical conditions, allergies, injuries, or additional needs - and any medication - you or you child have, for example, PND, joint abnormalities, allergies, respiratory conditions. If no, please write n/a in the field below. *

Emergency Contact Name (in case we need to contact someone for you in an emergency) *

First

Last

Emergency Phone Number *

I hereby agree to the following:

I recognize that yoga, as with any physical activity, carries a risk of physical injury, and I am fully aware of the risks and hazards involved.

I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any physical fitness program, including yoga. I represent and warrant that neither my baby nor I have any medical condition that would prevent our participation in yoga activities. I understand that it is my responsibility to detail any injuries, allergies, additional needs and health conditions on this form.

If taking part in baby yoga, I confirm that my infant has had their 6 or 8 week check and/or been confirmed free from any joint/skeletal disorders/abnormalities/conditions.

If taking part in baby yoga, I confirm that I have been cleared to return to gentle exercise by my health visitor/GP following my child's birth.

I understand that my baby should refrain from baby yoga or baby massage for 3 days after immunisations, in case of any side effects or soreness.

In consideration of being permitted to participate in the yoga/massage classes, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which I or my child might incur as a result of participating in the program.

In further consideration of being permitted to participate in the yoga/massage classes, I knowingly, voluntarily, and expressly waive any claim I may have against the instructor, the owner, or the leaseholder of the building for injuries or damages that I or my child may sustain as a result of participating in classes or workshops held by Lara Platten/Om Bodies.

I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above

Parent Name *

First

Last

Select One *

How did you hear about us? *

Internet Search Advertisement Friend Other

If Other please specify: *

Submit

Enrollment and waiver - Om Babies classes

Please complete all fields

Let me know.