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 the personal representative thereof, my heirs and assigns, I hereby forever release, hold harmless, defend and indemnify Grounded and Calm and 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 participation in Grounded & Calm LLC classes. I intend this release and indemnity to be 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 either Grounded & Calm LLC and their officers, directors, employees and agents, relating to any accident, incident or occurrence arising out of, or in connection with, my participation in Grounded & Calm LLC classes. In agreeing to 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. *While yoga is generally safe and beneficial, there is a possibility of injury, as with any physical activity. By participating, you agree to assume full responsibility for your own safety and well-being during the session. *While meditation is generally considered safe and beneficial, there is a small risk that it may trigger seizures in individuals with a history of epilepsy or other seizure disorders. By participating, you acknowledge this risk and agree to assume full responsibility for your well-being during meditation sessions. In agreeing to 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. I do hereby certify that my child, or the child for whom I am a legal guardian, has my permission to participate 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. My submission serves as my electronic signature, confirming my consent and agreement to the waiver. I Agree Thank you!We are looking forward to practicing mindfulness together!