{"content":[{"text":"Pencil on Paper Gallery, LLC \n Yoga Waiver & Release Form","bbox":{"left":0.285915,"top":0.172453,"width":0.4742190000000001,"height":0.06349000000000002}},{"text":"Name of Child: ___________________________________________","bbox":{"left":0.11781,"top":0.290245,"width":0.506595,"height":0.018948999999999994}},{"text":"Age: ________________","bbox":{"left":0.647827,"top":0.290245,"width":0.18710000000000004,"height":0.018948999999999994}},{"text":"Birth Date: _____/____/______","bbox":{"left":0.11781,"top":0.345232,"width":0.233254,"height":0.018948999999999994}},{"text":"Address: ________________________________________________________________________","bbox":{"left":0.11781,"top":0.400194,"width":0.720588,"height":0.018948999999999994}},{"text":"City: ________________________________________ Zip: ________________________________","bbox":{"left":0.11781,"top":0.454235,"width":0.7317980000000001,"height":0.018948999999999994}},{"text":"Phone: __________________________________","bbox":{"left":0.11781,"top":0.509222,"width":0.364302,"height":0.018948999999999994}},{"text":"Email: ___________________________________","bbox":{"left":0.11781,"top":0.564184,"width":0.37046,"height":0.018948999999999994}},{"text":"Emergency Contact Name: ________________________________________","bbox":{"left":0.11781,"top":0.619159,"width":0.56274,"height":0.018948999999999994}},{"text":"Emergency Contact Phone: ________________________________________","bbox":{"left":0.11781,"top":0.673212,"width":0.5640080000000001,"height":0.018948999999999994}},{"text":"I understand that yoga includes physical movements as well as an opportunity for relaxation, \n stress re-education and relief of muscular tension. As is the case with any physical activity, the \n risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. \n Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not \n recommended and is not safe under certain medical conditions. By signing, I affirm that a \n licensed physician has verified the good health and physical condition of my child to participate \n in such a fitness program. In addition, I will make the instructor aware of any medical conditions \n or physical limitations before class.","bbox":{"left":0.11781,"top":0.729058,"width":0.7555720000000001,"height":0.15196700000000007}}],"images_bbox":[{"left":0.117647,"top":0.090909,"width":0.199755,"height":0.10322}],"images_bbox_not_text_overlap":[{"left":0.117647,"top":0.090909,"width":0.199755,"height":0.10322}]}