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Upon filling out the registration form, you will be contacted by a representative from the Fraser Community League. They will arrange payment instructions and get you and your family onto the roster for our Family Yoga Fun Night! YIPPE!! HOORAY!
Family Yoga Fun Night Registration Form
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Indicates required field
Family Last Name
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Number of people attending in your family
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2
3
4
5
6 or more
Main Contact Parent
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First
Last
Email
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Phone Number
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Address
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City
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Postal Code
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Who is coming?
Name
*
Age
*
Name
*
Name
*
Age
*
Age
*
Name
*
Age
*
Name
*
Age
*
Name
*
Age
*
Name
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Age
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Please select the session you wish to register for
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April 27, 2018: 6:00-7:00 PM
How did you hear about the program?
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I wish to receive updates about current and future programs via email
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Yes
No
Question, comment, concern?
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GLOW YOGA KIDS RELEASE AND WAIVER OF LIABILITY
I, the parent or legal guardian of:
Child(s) Name
*
understand that yoga includes physical movements 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 Vanessa Pouliot, 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 signature below states my full acceptance and concurrence with the terms of this agreement.
Parent's Digital Signature
*
Date
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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 Vanessa 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.
Child(s) Name
*
Parent's Digital Signature
*
Date
*
Submit