Parental Sign-up Sheet for Planting your Dreams
Dates: 8/4/2019 & 8/11/2019
TImes: 10:00am- 2:00pm
Event Address: Shanti Heart Yoga, 18101 Boy Scout Rd, Odessa, FL 33556
Contact us at
I understand that this sheet is for me, the parent and or guardian, and there is a separate sign-up sheet for my daughter, which she must complete to participate in the program.
Name of Minor *
Your answer
Name of Parent/Guardian *
Your answer
Emergency Contact Name, Relationship, Phone Number *
Your answer
Parent/Guardian Phone Number, E-Mail, and Address (if the guardian and the emergency contact have the same #, write in " ".) *
Your answer
Why are you signing your daughter up for this program? *
Your answer
What do you hope your daughter learns/What do you think she requires from this workshop?
Your answer
What is she like in school/ a classroom setting?
Your answer
Will your daughter have reliable transportation to and from Shanti Heart on 8/4/2019 & 8/11/2019? (if not, please let us know.)
Your answer
Dietary restrictions *
[legal authorization here basically saying the parents agree to have us watch their kids for a few hours]
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