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Registration Release and Waiver of Liability (ADHD/Autism)
Registration, Release and Waiver of Liability RCY for ADHD/Autism
Course Location and Date:
Address Line 2
State / Province / Region
ZIP / Postal Code
Antigua and Barbuda
Bosnia and Herzegovina
Central African Republic
Congo, Democratic Republic of the
Congo, Republic of the
Northern Mariana Islands
Palestine, State of
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
Virgin Islands, British
Virgin Islands, U.S.
Your email address will be used to send you occasional emails about the program, including a monthly newsletter with a free lesson plan. It will not be shared with any third party, and you may unsubscribe at any time.
List any physical conditions which may affect your participation in this course:
Completed RCY Level 1-2
Completed RCY Level 1-3
Not completed another RCY training
Let us know if you have completed any other RCY training.
Have you applied to Radiant Child Yoga certification training?
No, I haven't
Relationship to you
How did you hear about this course?
Please initial beside each statement below to indicate your understanding and agreement to abide it.
Though Radiant Child LLC (RCY) endeavors to impart the importance of integrity and ethics in children’s yoga teachers, I agree that RCY is not responsible for the actions of those who have taken training in this course.
I understand that after submitting my practicum to the RCY teacher via email, I will receive my RCY certificate and an RCY 30-hour digital badge that is entirely appropriate to display on flyers and websites in recognition of completion of my training. It is entirely appropriate to list RCY in my course bio or resume as a statement of my training, and describe my children’s yoga classes as “Radiant Child Yoga inspired”.
I understand that the content of RCY training course and manuals are copyrighted by Shakta Khalsa, and as such are legally the intellectual and physical property of the originator. Any reproduction whether in written or verbal form must be done with the written consent of Shakta Khalsa and/or Shining Circle Inc./Radiant Child LLC, and any references to this content must be credited to RCY, with verbal/written reference to www.childrensyoga.com.
WAIVER AND RELEASE OF LIABILITY
Terms and Conditions
I hereby agree to the following:
I am participating in yoga teacher training, workshops, and yoga classes and other exercise and healing arts activities (collectively, the “Activities”) offered by Shining Circle, Inc./Radiant Child LLC (“RCY”) and/or its owners, instructors, teachers, workshop presenters, employees and independent contractors.
I recognize that I must be in good physical and mental health to participate in the Activities. I understand that the Activities require physical exertion and I represent and warrant that I am physically fit and I have no medical condition which would prevent my full participation in the Activities. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the Activities and to follow my physician’s advice. I understand that RCY reserves the right in its absolute discretion to refuse my participation in an Activity on medical or fitness grounds.
I am in proper physical condition to participate in the Activities, and I am aware that participation could, in some circumstances, result in physical illness or injury such as changes in blood pressure and heartbeat, fainting, and potentially heart attack. I also understand that I could experience muscle, back, or bone injuries during the Activities. I understand my physical limitations and am sufficiently self-aware to stop physical activity before I become ill or injured. I understand that it is my continuing responsibility to inform RCY of any previous medical conditions, injuries or surgeries prior to my first class and any future changes to my medical conditions.
In consideration of being permitted to participate in the Activities, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the RCY Activities.
In further consideration of being permitted to participate in the Activities, I knowingly, voluntarily and expressly waive any “Claims” (as described below) I may have against RCY, its owners, members, employees, and/or its instructors, teachers, volunteer staff, and/or independent contractors (each, a “Released Party”) for any Claim that I may sustain as a result of participating in the Activities even if the Claim arises from the carelessness or negligence of any Released Party or anyone else. I agree to indemnify and hold harmless each Released Party from any loss or liability incurred in defending any Claim made by me or anyone making a Claim on my behalf, even if the Claim is alleged to or did result from the carelessness or negligence of any Released Party or anyone else. “Claims” include, but are not limited to, any and all liabilities, claims, demands, expenses, fees, legal actions, rights of actions for damages, personal injury, mental suffering and distress, or death that I may suffer, my children my suffer or that my unborn child may suffer (including any legal fees or expenses) in connection with participation in any Activity.
I, my heirs or legal representatives forever release, waive and discharge and covenant not to sue any Released Party for any Claim caused by any negligence or other acts of a Released Party.
I hereby understand that RCY from time to time may photograph or video classes or training events and place such photographs and videos on its Website or other marketing materials. I hereby consent to the use of my image that may appear in any such photograph or video and waive any rights of ownership or compensation for use of my image for RCY promotional materials. Please check here if you do NOT consent. We will respect your choice.
This agreement shall be construed in accordance with, and governed by, the laws of the Commonwealth of Virginia.
I acknowledge that I have carefully read this release and waiver of liability and fully understand its contents. I voluntarily and knowingly agree to the terms and conditions stated herein. I am aware that by signing this release and waiver of liability, I am giving up substantial rights, including my right to sue and certain legal rights my heirs, next of kin, executors, administrators and assigns may have against any Released Party.