School program Waiver

please READ AND complete the following if your child is attending a firefly yogis in school program:

I, the participant(s)/the parent of the participant(s) hereby assume all risk and hazards incidental to participation in any and all in studio/out of studio activities, including transportation to and from activities, and I hereby waive, release, absolve, indemnify and agree to hold harmless the organizers, owners, sponsors, supervisors, instructors, participants, owners of the premises providing the activities and persons transporting myself/my child to and from activities for any claim arising out of injury to myself/my child/Children. I hereby grant Firefly Yogis permission to use my or my minor(s) likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. Individual Signature (if over 18) or Parent for Children under 18.

Name
Name
Participants Name *
Participants Name
Phone *
Phone
Program Date
Program Date