Summer Camp Registration Form

Kids Yoga Camp Registration, 2020

* Indicates required field

Child's Name *

First

Last

Child's Age *

Gender *

Are you registering more than 1 child? *

No Yes

Second Child's Name *

First

Last

Child's Age *

Gender *

Third Child's Name *

First

Last

Child's Age *

Gender *

Parent's Name *

First

Last

Email *

Phone Number *

I give permission for Glow Yoga Kids to send me urgent updates via text message *

Yes No

I wish to receive updates about current and future programs via email *

Yes No

Address *

City *

Postal Code *

Please select the camp(s) you wish to register for *

Option 1 Option 2 Option 3

Question, comment, concern? *

How did you hear about the camp? *

The personal information collected on this form is in order to establish a client’s identity and to assist our teachers in providing the finest instruction and classroom environment for your child. All information will remain private and confidential.

Waiver

I, the parent or legal guardian of

Child(ren)'s Name(s) *

a minor, understand that yoga includes individual physical movements, supportive touch, group work as well as an opportunity for relaxation, stress reduction, and relief of muscular tension. I declare that my child is physically able and ready to participate in the Glow Yoga Kids program. I understand that Glow Yoga Kids will take all reasonable care to ensure that the classes are safe. However, as is the case with any physical activity, the risk of injury, even serious or disabling, is always present and can not entirely be eliminated. If my child experiences any pain or discomfort, my child will listen to his/her body, adjust the posture and ask for support from the teacher or practitioner. Yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I affirm that I alone am responsible to decide whether my child practices yoga.

I hereby agree to irrevocably release and waive Glow Yoga Kids to any claims that I have now or hereafter may have against any and all Glow Yoga Kids Instructors. I have read and fully understand the above agreement terms and it is expressly agreed that Robyn Snow, Glow Yoga Kids and it’s agents and independent contractors shall not be held liable for claims, demands, injuries, damages, actions or causes of action, whatsoever, to my child or property arising out of or connected with the yoga program or due to a pre-existing condition not disclosed by myself or other persons responsible for my child. My digital signature below states my full acceptance and concurrence with the terms of this agreement.

Parent Name *

First

Last

Date *

Photo Release

Glow Yoga Kids has the goal to promote kids yoga within our community and city, therefore we use a website, social media accounts and paper/electronic advertisements to assist in achieving this goal.

I give my permission for Robyn and Glow Yoga Kids to use my child’s image (photo or video) for online and print promotions of kids yoga and teaching seminars. My child will not be identified in any way.

Do you give permission? *

Child(ren)'s Name(s) *

Parent Name *

First

Last

Thank you for taking the time to fill out this form! We look forward to sharing our magical, loved-up and joy-filled yoga camp with your kiddo(s)!

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