Enrollment is first come, first serve basis. Spots are not held unless enrollment form and full payment is received. Participants will be informed of cancellations at least one week prior to class. In the case that laughing heart yoga/Crossover Yoga Project needs to cancel, refunds will be provided in full to registered students. Sorry, no refunds. Please note that registrations cannot be transferred to other participants. Please print and bring this form to your first class. 

laughing heart yoga
​                                                                       empowering kids and teens through yoga & creativity

 




Class/Time/Price:_____________________________________________________________________________


Participant’s Name:_______________________________________________________Age:_______________________

Parent Name: ______________________________________________________________________________________

Home Phone:_____________________Work:_____________________Cell:____________________________________

Email:_____________________________________________________________________________________________

Emergency Contact: __________________________________________Phone:__________________________________

Explain any conditions that may limit student’s participation  _________________________________________________

How did you hear about us?______________________________________________________________________


AGREEMENT OF RELEASE AND WAIVER OF LIABILITY

I, _________________________________________________________ hereby agree to the following:                                                    

                             student name
1. That I am participating in yoga/mediation classes or health programs or workshops offered by Elisha Simpson/Crossover Yoga Project and during which they will receive information and instruction about yoga and health. I recognize that yoga requires physical exertion that may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. 2. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in yoga/mediation classes or health programs or workshops. I represent and warrant that the participation is physically fit and has no medical conditions that would prevent the participant’s full participation in the yoga/mediation classes or health programs or workshops. 3. In consideration of being permitted to participate in yoga/mediation classes or health programs or workshops.  I agree to assume full responsibility for any injuries, damages, known or unknown, which I might incur as a result of participating in the program which I might incur as a result of participating in the program. 4. In further consideration of being permitted to participate in yoga/mediation classes or health programs or workshops, I voluntarily and expressly waive any claim that I may have against Elisha Simpson/Crossover Yoga Project for injury or damages that I may sustain as a result of participating in the program. 5. I, my heirs, or legal representatives forever release waive, discharge and covenant not to sue Elisha Simpson/Crossover Yoga Project for injury or death caused by their negligence or other acts. 6. I agree to give Elisha Simpson/Crossover Yoga Project permission to use photographs of myself or my child for any Elisha Simpson/Crossover Yoga Project promotional materials, Internet use, Facebook postings, etc. I understand that my child will not be identified by name, nor will any compensation be extended for such use. 7. I have read the above release and waiver of liability and fully understand its content. I voluntarily agree to the terms and conditions stated above.

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Signature of participant’s parent                                                                       Date

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Print Name