Marluna Yoga Waiver

Please tell us what you are filling out this waiver for:

Please tell us about yourself and your child:

Guardian First name

Guardian Last name

Phone

Child's First name

Child's Last name

Child's Birthday

Month

Day

Year

Emergency Contact Name

Emergency Contact Phone

MEDICAL CONDITIONS/ ALLERGIES/LIMITING FACTORS (IF ANY): I confirm that my child is physically able to participate in yoga activities. If my child has any medical conditions, allergies, or limitations, I have disclosed this information below.

Physically able, no medical conditions

Other

FOOT RUBS DURING SAVASANA: During relaxation (Savasana), optional light, calming foot rubs may be offered to children as a way to deepen relaxation. Consent is asked each time, and children may decline with no effect on participation.

Yes, I consent to my child receiving foot rubs during Savasana

No, I do not consent to my child receiving foot rubs during Savasana

PHOTOGRAPHY AND MEDIA RELEASE: I grant Marluna Yoga permission to photograph or record my child during yoga for use in promotional materials, social media, and the Marluna Yoga website. I understand that my child’s name will not be used without consent.

Yes, I consent to photography/media use

No, I do not consent to photography/media use

WAIVER

Consent to Participate

I, the undersigned parent/guardian, hereby give my consent for my child, listed above, to participate in the yoga classes, workshops, and related activities conducted by Marluna Yoga. I understand that the classes will involve physical activity, breathing exercises, and mindful practices suitable for children.

Acknowledgment of Risks

I acknowledge that while Marluna Yoga instructors will take reasonable measures to ensure the safety of all participants, there are inherent risks associated with physical activities, including but not limited to:

Physical strain or discomfort,
Minor injuries (e.g., muscle strains, sprains),
Rare but possible severe injuries.

Release of Liability

I hereby release and hold harmless Marluna Yoga, its instructors, staff, agents, and representatives, from any and all claims, demands, and causes of action arising from my child’s participation in yoga activities, including any optional foot rubs during Shavasana, to the fullest extent permitted by law. I understand that Marluna Yoga is not responsible for any injuries or damages that may occur as a result of my child’s participation in these activities.

Medical Consent

In the event of a medical emergency, I authorize Marluna Yoga and its staff to secure medical assistance for my child and to contact the emergency contact listed above. I understand that all medical expenses will be my responsibility.

Please type your full name here

I accept the terms and conditions