Consent & waiver - children & babies

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.

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* 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) *

Child's Name *

First

Last

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

Please detail any medical conditions, allergies, injuries, or additional needs your child has. If no, please write n/a in the field below. *

Second Emergency Contact Name (in case of failure to contact Parent/Guardian) *

First

Last

Second emergency Phone Number *

I hereby agree to the following:

My child (if applicable) has permission to attend yoga classes with Lara Platten, trading as Om Bodies.
and/or
My child/baby and I are participating in classes or services during which she/he will receive information and instruction about yoga and health. I recognise that yoga requires physical exertion, which may be strenuous and may cause 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 child’s/baby's participation in any physical fitness program, including yoga/baby massage.
I represent and warrant that my child/baby has no medical condition that would prevent her/his participation in physical fitness activities.
If taking part in baby yoga, I confirm that my baby has had the 6-8 week medical check with a health visitor or GP confirming that they have no medical issues and their hips are healthy.
I understand that it is my responsibility to detail any injuries, allergies, additional needs and health conditions on this form.

In consideration of being permitted to participate in the yoga/baby massage classes, I agree to assume full responsibility for any risks, injuries or damages, known and unknown, which my child/baby or I 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 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

Caring for little bodies.

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Let me know.