I certify that I am the parent or legal guardian of the child named in this form and do hereby consent to his/her participation in the yoga classes for kids conducted by the Blossom Yoga Center.  I certify that my child is capable of participating in the program and have disclosed all relevant information regarding my child to the Blossom Yoga Center

On behalf of myself, my estate and the personal representative thereof, my heirs and assigns, I hereby forever release, hold harmless, defend and indemnify the Blossom Foundation, their officers, directors, employees and agents, from any and all costs, claims, losses, liabilities or damages arising from or in any way related to, my child’s participation in the Kids Yoga classes conducted by the Blossom Yoga Center.  

I intend this release and indemnity to be effective, regardless whether the claim of liability is asserted in negligence, strict liability in tort, or other theory of recovery. For myself, my estate and the personal representative thereof, my heirs and assigns, I covenant and agree to make no claim, nor to institute any suit, action or proceeding against the Blossom Foundation or its officers, directors, employees or agents, relating to any accident, incident or occurrence arising out of, or in connection with, my child’s participation in the Kids Yoga classes conducted by the Blossom Yoga Center.

In signing this release, I have fully informed myself of the content of this release and I have reviewed it and understand what it means, and this release is signed as my own free act and deed.

Yoga sessions may be recorded for quality and monitoring purposes.  I give permission for my child to be photographed and/or videotaped while participating in the yoga class.