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TdVA Yoga Club Spring 2018 Registration
Grades K-5
Friday mornings 7:30-8:20 am
February 2, 2018 - May 18, 2018
Cost: $45 for new students (includes a yoga mat and journal); $38 for returning students (includes journal; kids should bring their yoga mat)
*Sibling discounts and need-based scholarships available. Please contact Kim Wilson at peakkidsyoga@gmail.com for more information.
Child's Name *
Your answer
Date of Birth *
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Grade *
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Teacher's Name *
Your answer
Are there any special needs or injuries that may impact your child's participation in yoga? *
Your answer
Parent/Guardian Name *
Your answer
Telephone Number *
Your answer
Email Address *
Your answer
How would you like to be informed of yoga club information (important info, cancellations, etc)? *
Emergency Contact Name *
Your answer
Emergency Contact Telephone Number *
Your answer
Informed Consent & Waiver of Liability
Please read the Informed Consent & Waiver of Liability below and check the box below to confirm your understanding and agreement to these terms.
I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education, and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. In consideration of the benefits of the instruction provided by PEAK Kids Yoga, I do hereby allow my child permission to participate in this yoga program and do hereby waive claim and release PEAK Kids Yoga and any class instructor for claim or liability for any injury or accident occurring on or arising from my child's participation in the instruction. In addition, I authorize emergency first aid care to said child in the event s/he becomes injured or ill during the instruction. If the parents and/or guardian of the child are not immediately available at the telephone number(s) provided above, I further authorize Kimberly Wilson or any representative of PEAK Kids Yoga to retain the services of a physician or other competent emergency medical professional to treat the child. I have read and fully understand and agree to the terms of this Liability Waiver Agreement. I am checking the box below voluntarily and recognize that this serves as complete and unconditional release of all liability to the greatest extend allowed by law in the State of Colorado. *
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Occasionally we take photographs during class to provide class updates to parents and for promotional purposes only. Please check below to consent to photography during the class session. *
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Refunds, Missed Classes & Makeup Policy *
If you need to cancel your child's class registration, please contact Kimberly Wilson at peakkidsyoga@gmail.com with your child's name and reason for the refund request. Refunds made prior to the first class will receive a full refund minus a $10 administrative fee; refunds requested after the first class but before the second class will be issued a 50% refund. No refunds will be given after the 2nd class of the session. No partial refunds will be issued for classes missed by the student for any reason. Classes that are cancelled due to inclement weather or instructor illness will be re-scheduled.
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