Yoga Class with Champagne Movement and Yoga
Come enjoy a relaxing hour of yoga with Matt at our Carleton Place location. 
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Full Name *
Email address *
Phone number *
How would you describe your experience with yoga to date? *
Do you have any medical conditions or allergies we should be aware of? *
I/We agree to release from responsibility the Champagne School of Dance and Champagne Movement and Yoga including all teachers, instructors, dancers, guest teachers and studio space (including but not limited to those located at 41 Framingham Crescent, 2499 8th Line Road, and 55 Lansdowne Avenue and/or any other space utilized for dance lessons and/or practices) from any cause of action, claims, or demands now and in the future. I/we will not hold The Champagne School of Dance and Champagne Movement and Yoga, including all teachers, dancers, guest teachers and studio space (including but not limited to those located at 41 Framingham Crescent, 2499 8th Line Road, and 55 Lansdowne Avenue and/or any other space utilized for dance lessons, yoga sessions and/or practices) liable for any personal injury including: scrapes, bruises, cuts, sprains, fractures, broken bones, concussions or death or any personal property damage/loss, which may occur on before, during or after class.
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I/We agree that the Champagne School of Dance, and Champagne Movement and Yoga, including all teachers, dancers and guest teachers and studio space (including but not limited to those located at 41 Framingham Crescent, 2499 8th Line Road, and 55 Lansdowne Avenue and/or any other space utilized for lessons, yoga sessions and/or practices) are not responsible for any injuries, including scrapes, bruises, cuts, sprains, fractures, broken bones, concussions or death that may occur during online dance lessons. I/We agree to ensure that the physical environment in which I/my minor completes a yoga session is safe from injury, and suitable for the movements expected to be executed throughout the session.
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Due to the COVID-19 pandemic, I/We agree that I/my minor will not attend yoga sessions if they are exhibiting any signs sickness. I/We agree to inform instructors Matt Champagne should I/my minor present with any illness after attending a yoga session.
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I/We give permission for the Champagne School of Dance, Champagne Movement and Yoga, Matt Champagne, Fiona Champagne, Chelsea Laplante and/or Ainsley Waldorf to use images and/or videos of me or my minor for the school’s social media pages, including but not limited to advertising and community initiatives (including the Ottawa Highland Dancing Association).
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I/We give permission for the Champagne School of Dance, Champagne Movement and Yoga, Matt Champagne, Fiona Champagne, Chelsea Laplante and/or Ainsley Waldorf and any other teacher or dancer within the school to perform CPR, First Aid and/or any other necessary measures in the event of a medical emergency.
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