Diamondtaire Stars Ambassadors Form
Name of student *
Age *
D.O.B *
Email *
Address *
P.O.Box *
Emirates *
Residential Address *
Mobile Contact of Child *
Parent Contact No. *
Name of parent *
Name of School *
No. of hours available for learning Yoga in one month *
Can you commit to Yoga Sadhna with Gems Of Yoga for: *
Do you like to learn Yoga or Teach Yoga or Both? *
*
Yes
No
Do you have any health complaint existing now ?
Is it permissible for you to learn Sanskrit ?
How will you promote Yoga in your school ?
How much time for SEVA yoga can you volunteer in 1 month apart from learning and teaching Yoga ?
Are your parents aware that you have signed up for the Diamondtaire Star Programme.
Are you interested in our Yoga Fellowship Program ?
Are you open to travel to other Emirates to teach yoga?
Any allergies or food restrictions that you should inform us about: *
Classes you are signing for: *
Release and Waiver of Liability
I, the parent or legal guardian of below-named student, a minor, understand that my child will be participating in a yoga class or classes at Gems Of Yoga during which he/ she will receive instruction about yoga and actively participate in yoga exercise. I understand that yoga requires physical movement and bodily exertion which may result in an accident of physical injury. In consideration of being permitted to participate in Yoga Classes I, for myself and the student and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify Gems Of Yoga, Sunita Bhalla, the owners, and the instructors from and against all claims, liabilities, damages, or causes of action arising out of or in connection with my child’s participation in the classes, without limitation.
Signature of Parent/Guardian *
Type your Full Name
Date
MM
/
DD
/
YYYY
Photo Release: I give consent for my child’s picture to be taken and used to promote Animal Yoga For Children *
Fire up! the Sun & Moon in You!
Thank You
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