Student Name First Name Last Name Parent/Guardian Name * First Name Last Name Email * Waiver/Release of Liability: * By agreeing to this waiver, I acknowledge that Sharon Paquette Lose operates under Grounded & Calm LLC and that she is contracted to Encompass Academy through this LLC. I understand that Sharon Paquette Lose and Grounded & Calm LLC are one and the same for the purposes of this agreement, and by agreeing to this waiver, I release both Sharon Paquette Lose and Grounded & Calm LLC from any liability. On behalf of myself, my estate, and my heirs and assigns, I hereby release, hold harmless, defend, and indemnify Grounded & Calm LLC, its officers, directors, employees, and agents, from any and all claims, losses, liabilities, or damages arising from or related in any way to the participation of the student named below in Mindfulness and Nature Enrichment classes offered by Grounded & Calm LLC. This release applies regardless of whether the claim of liability is based on negligence, strict liability, or any other theory of recovery. I covenant and agree that neither I, nor my estate, heirs, or assigns will bring any claim or legal action against Grounded & Calm LLC, its officers, directors, employees, or agents, for any accident, incident, or occurrence arising out of or in connection with the participation in these classes. I acknowledge that while mindfulness, nature walks (off-campus), and reflective journaling practices are generally safe and beneficial, there is a possibility of injury or unforeseen physical responses. By allowing participation, I assume full responsibility for the above-named child’s safety and well-being during the sessions. Additionally, I understand that while meditation is generally considered safe, there is a small risk of triggering seizures in individuals with a history of epilepsy or other seizure disorders. By allowing participation, I acknowledge this risk and assume full responsibility for the above-named child’s well-being during these sessions. I hereby certify that I am the parent or legal guardian of the student named below and give my full consent for their participation in this class. By entering my name and email address into this form, I acknowledge that I have read, understood, and agree to the terms and conditions of this waiver on behalf of the student named below. My submission serves as my electronic signature, confirming my consent and agreement to this waiver. I Agree Thank you!We are looking forward to practicing mindfulness together!