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Children/Teen Yoga Consent Form

I desire to have my child engage voluntarily in the Contemplative Practices Resource Center
yoga sessions in order to attempt to improve wellness.
I understand that the purpose of the movement programs is to develop and maintain
overall wellness, flexibility, joint mobility and decrease stress. All sessions include warm-up,
breathing, and yoga postures. The programs include, but are not limited to Kind/gentle yoga,
restorative yoga, chair yoga, yin yoga, children’s yoga, teen yoga & various fitness modalities.
I understand that my child is to listen to the feedback their body is giving them. They will be
instructed to monitor how their body is feeling throughout the session, should any pain occur,
they will cease participation and inform the instructor. I understand that my child may rest at any
time during class.
In signing this consent form, I affirm that I have read this form in its entirety and I understand
the nature of the program. I also affirm that my questions regarding the program have been
answered to my satisfaction.
In signing this form, I affirm that I understand that yoga is not a substitute for medical attention,
examination, diagnosis, or treatment. I should consult a physician prior to having my child start
any activity program, including yoga. I recognize that it is my responsibility to notify the teacher
of any serious illness or injury before every yoga class.
In the event that medical clearance must be obtained prior to participation in the program, I agree
to consult my child’s physician and obtain written permission from the physician prior to the
commencement of any exercise program.
Also, in consideration for allowing my child to participate in this yoga/exercise program, I agree
to assume the risk of such exercise, and further agree to hold harmless the instructor, Tracy Lake,
Contemplative Practices Resource Center, it’s employees and agents from any and all claims,
suits, losses or related caused of action for damages, including, but not limited to, such claims
that may result in injury, accidental or otherwise, during or arising in any way from the sessions.

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