Summer Holistic Yoga Camp Registration - 2017
Welcome to Yoga Bharati Summer Holistic Camp 2017 for Kids and Youth. Summer camps are held at 2 locations. Please visit website link https://yogabharati.org/events/ for more details.
Yoga Bharati Main Center - 20445 Prospect Rd Suite #1, San Jose, CA, 95129
Does your child attend Yoga Bharati classes presently? *
Child's name (First and Last name) *
Your answer
Date of birth *
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Child's Age *
Choice of Summer Camp Location *
City, Zip code *
Your answer
Please list any food Allergies or medical conditions. *
Your answer
Parents Information
Your name *
Your answer
Your email address *
Your answer
Cell Phone number *
Your answer
Emergency Contact name and number
Your answer
Summer Camp Details
Fees and Discounts

One camp (One week) - $210
One camp (two weeks) - $395
Two camps (four weeks) - $750
Youth Camp - $175

Camp (three weeks) - $595

April 1st - Early Bird discount - $25 for one week; $55 two weeks; $80 for three weeks and $90 for four weeks camps.
May 1st - Advanced Rate (Extended discount - $25 per camp discount for 2 week camps and $50 for 4 week camps only
* Deposit $200 for Summer camp - Full fee due by May 1st.

Pleasanton Location (6-11 years)
Please choose the most appropriate option you are interested in. Camp Times - 9.30 am to 12.30 pm. 4410 Clovewood Lane, Pleasanton, CA, 94588; Call Shobha at 408 689 1762 for details.
Cupertino Location (6-11 years)
Please choose a most appropriate option you are interested in. All 6-11 years Camps are half day options 9.30 am to 12.30 pm. Yoga Bharati Main Center - 20445 Prospect Rd Suite #1, San Jose, CA, 95129; Call 408 341 9642 for details. Please mention the week dates if they are different from the options below in the 'OTHER'
Cupertino Location - Explore Yoga Camp 12 + years.
July 31st - Aug 4th Explore Yoga camps are 3.30 to 6.30 pm. Please select yes/no.
Please pay here.. *
Paypal transaction number if applicable
Your answer
Informed Consent and Release of Liability
Liability Waiver you signed
1. In consideration of being allowed to participate in the activities of yoga and associated exercises (asanas) conducted by Yoga Bharati and to use its rented facilities and equipment in addition to the payment of any fee or charge, I do hereby waive, release, and forever discharge Yoga Bharati, its instructors, volunteers, representatives and contractors from any and all responsibilities or liability from injuries or damages resulting from my participation. I also do hereby waive, release, and forever discharge the premises (where yoga is conducted), its trustees, and employees, representatives from any and all responsibilities or liability from injuries or damages resulting from my participation in any activities or my use of the facilities.

2. I understand and am aware that strength, flexibility, yoga, and other exercises are a potentially hazardous activity. I also understand that yoga and fitness activities involve a risk of injury and even death, and that I am or my child is voluntarily participating in these activities with knowledge of risks and dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or death. This waiver is also binding on all my heirs, executors, and others acting on my behalf.

3. I do hereby further declare myself or my child to be suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation in this yoga programs. I understand that it is my responsibility to consult with my or my child's physician prior to initiating any yoga program. I also understand it is my responsibility to consult with my or my child's physician about all health-related changes that may result from the yoga program. I understand that certain physiological changes are associated with exercise and yoga, some of which can pose health risks. I acknowledge that I have or my child has either had a physical examination and been given permission by the physician to participate or that I have decided to participate or have my child participate in activities and use equipment without the approval of any physician and do hereby assume all responsibility for my or my child's participation in the activities.

4. I understand it is my responsibility to notify my instructor(s) of all-physical conditions, injuries, and illnesses

I accept the above. Print your name here *
Your answer
Today's Date *
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