Green Lotus Kids Yoga Camp Intake & Liability Waiver

Thank you for taking the time to fill out this form. Please thoroughly answer the following questions to help us to better understand your child and their unique self.

If you have questions, please email Lindsay at Lindsay@greenlotusyogactr.com

Email

Name of Participant

First Name

Last Name

Participant's Age

Parent or Guardian's Name

First Name

Last Name

Parent or Guardian's Phone Number

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Who will be picking up your child?

First Name

Last Name

Does the participant have any allergies, sensitivities, dietary restrictions, or medical information necessary to share?

Is there anything else you would like us to know about the particpant?

Waiver Agreement

Please read this waiver carefully before signing.

I, the undersigned parent or guardian of the child named above consent to their participation in Green Lotus Yoga & Healing Center’s Kids Summer Camp, which may include yoga, movement, meditation, crafts, and outdoor activities. I acknowledge these activities carry inherent risks—such as injury, strain, or illness—and assume full responsibility for my child’s safety. I will disclose any medical conditions, consult a physician if needed, and keep my child home if they exhibit symptoms of a communicable illness including covid. On behalf of myself and my child, I waive and release Green Lotus Yoga & Healing Center and its staff from all liability and agree to indemnify and hold them harmless. I have read, understand, and voluntarily agree to this waiver.

I have read and agree to the above waiver.

First Name

Last Name

Kids Yoga Camp Intake and Liability Waiver

Green Lotus Kids Yoga Camp Intake & Liability Waiver

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