Parent/Guardian Consent Form

  • Your Details

  • MM slash DD slash YYYY
  • Your Child's details

  • MM slash DD slash YYYY
  • Your child will be participating in a Mat Pilates class on Wednesdays from 2:00pm - 2:45pm

    A Mat Pilates class is a form of exercise that focuses on core strength, flexibility, and overall body conditioning. Conducted on a mat, participants perform a series of controlled movements and exercises designed to engage the muscles, improve posture, and enhance body awareness. Light hand weights, resistance bands and small pilates balls may be used during the classes.
  • Class location - Brightwater Wellness Hub, Mountain Creek

  • Instructor - Kristy Graham from Shine Yoga

  • Please read carefully before signing.

    I acknowledge that I have been informed of the nature of the Pilates class and understand that my child will be engaging in physical activities that may involve stretching, strength training, and flexibility exercises.
    ❖I confirm that my child is in good health and has no medical conditions or physical limitations that would prevent them from participating in the Pilates class.
    ❖If there are any health concerns or conditions, I have communicated them to the instructor.
    ❖ I am aware that while the Pilates class will be conducted with safety precautions, there may be inherent risks associated with physical activities, and I release Shine Yoga and Kristy Graham from any liability in the event of injury.
    ❖ I understand that Shine Yoga, Kristy Graham and all teachers, substitutes, employees, and affiliates can not make a determination about the safety of a yoga and pilates class for each individual person. Only my child's doctor can make such a determination. I understand that if my child moves with care, intelligence, safety and self-awareness, injury is unlikely. Should injury occur or complications arise, Shine Yoga, all teachers, substitutes, employees, and affiliates are absolved of all responsibility.
    ❖I, the undersigned parent/legal guardian of the above-named child, hereby grant consent for my child to participate in the Pilates class organised by Shine Yoga at the Brightwater Wellness Hub, 69-79 Attenuata Drive, Mountain Creek, on Wednesdays from 2:00pm - 2:45pm.

    I FURTHER STATE THAT I HAVE CAREFULLY READ THE FOREGOING RELEASE AND ITS CONTENTS. I FULLY AGREE WITH IT AND UNDERSTAND IT.
  • DD slash MM slash YYYY
  • This field is for validation purposes and should be left unchanged.