Liability – Registration Form

I want to ensure that everyone who participates in Colibri Kids Yoga with Kara-Lee has a safe, enjoyable experience. So please complete the form below and hit SUBMIT at the bottom of the page.  I look forward to working with your child!

YOGI (Child) Required






PARENT/GUARDIAN









EMERGENCY CONTACT




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I, individually and as parent/guardian of the minor identified above, hereby acknowledge the following notices and grant Colibri Kids Yoga with Kara-Lee Ruotolo the following release:

Liability Release: I acknowledge and fully understand that my child will be engaging in physical activities that may involve some risk of injury. I acknowledge that I have been advised to consult with my child’s physician with respect to any past or present injury, illness, health problem or any other condition or medication that may affect my child’s participation in the NGY program at YoBe. I assume the foregoing risks and accept personal responsibility for any personal injury sustained by my child and discharge and hold harmless Colibri Kids Yoga, its owners, directors, members, officers, teachers, employees and agents from any claim, cause of action or liability for damages arising from any personal injury to my child or other persons or property caused by my child’s participation in the Colibri Kids Yoga program provided.

Photographs: I acknowledge that my child may be photographed during these classes and these photographs, which shall be owned by Colibri Kids Yoga, may appear in Colibri promotional materials unless otherwise specified. No child whose photograph is used will be identified by name, nor will any compensation be extended for such use.

YES- You may take photosNO photos please

Essential oils: I understand that essential oils and aromatheraphy may be used during yoga class. I do not hold Colibri Kids Yoga with Kara-Lee Ruotolo liable for any injuries or negative effects my child may experience as a result of use of any products during the lesson.

Cancellations and Changes: Missed classes are non-transferable and non-refundable. If a written request is received 24 hours before the yoga class or event, a pro-rated refund will be issued less a $25 processing fee. The schedule is subject to change; Colibri Kids Yoga reserves the right to combine or cancel classes and/or modify teachers.

Liability: My child will be involved in physical activity that may result in injury. I have been advised to consult with my child’s physician regarding any past or current health issue (including skin allergies or sensitivity) or injury that may affect my child’s participation in Colibri Kids Yoga with Kara-Lee classes. I assume these risks and hold harmless Colibri Kids Yoga, its owners, agents, employees and teachers from any claim, cause of action or liability for damage arising from any personal injury, illness or other health issue caused to my child or other persons or property caused by my child’s participation in any Colibri Kids Yoga programs or classes.

Electronic Signature of Parent or Guardian ( *required )