Kid's Yoga Holiday Workshop Registration
Saturday, December 16th from 1p.m. - 4p.m. at Sterling Hot Yoga Works Mobile
Registration form and payment must be received in order to reserve your child's spot.
Child's Full Name *
Your answer
Child's Age *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Parent/Guardian's Full Name *
Your answer
Phone Number *
Your answer
Email Address
Your answer
Emergency Contact and Phone Number *
Your answer
Please list any allergies, physical limitations or concerns. *
Your answer
I acknowledge and fully understand that my child or children, listed above, will be engaging in physical activities that may involve some risk of injury. I acknowledge and have been advised that it is my responsibility to consult with my or my child’s physician with respect to any past or present injury, illness, health problem or any other condition or medication that may affect my or my child’s participation. I assume the foregoing risks and accept full personal responsibility for any personal injuries sustained by my child or myself which might incur as a result of participating in this program and discharge and hold harmless Sterling Hot Yoga Works, its owners, directors, members, employees and Cassidey Holder from any claim, cause of action or liability for damages arising from any personal injury to myself or my child or other persons or property caused by myself or my child’s participation in the this program. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms