Registration: Yoga for the New Year

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You are registering for Yoga for the New Year
Mondays 4:30-5:15pm
January 15 - February 19

This will be a slow flow yoga class designed to refocus your mind and body on the work God is doing in and through you, and incorporating Scripture meditation and worship music to strengthen your body and your spirit.

>>This class is suitable for beginners or advanced students and is open to women and men. <<

Taught by registered Holy Yoga instructor, Melanie Eccles
Location: Monroe Free Methodist Church (3928 E. Dunbar Rd. Monroe, MI)

$30 for 6 week class, due at first class via cash or check (to Melanie Eccles) or paid via PayPal.

First Name *

Last Name *

Birth Date (If under 18)

YYYY

Guardian/Parent Name (if under 18) *

I am a returning registrant

yes!

No, I'll need to complete the registration form

Clear selection

required for first time registrants

Cell Number

required for first time registrants

Would you like to receive text notifications?

required for first time registrants

yes

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Mailing Address

required for first time registrants

What is your prior yoga experience?

Are you new to yoga? Have you done a few classes via youtube? Do you practice regularly?

Do you have any questions or suggestions?

I understand that the $30 registration fee will be due at the first class. (Drop in Rate = $10) *

Cash or check to "Melanie Eccles" or visit www.paypal.me/MelanieEccles

yes, I will bring $30 payment to the first class or $10 per individual session

I will pay online using Paypal (www.paypal.me/MelanieEccles)

I would like information about financial assistance

Required

Waiver *

By signing below, I hereby consent as a participant in Holy Yoga classes and agree to assume all of the risks involved. I understand that Holy Yoga does not provide medical insurance relative to accidents, injuries, and/or death as a result of program related activities; and that I can not hold Holy Yoga or affiliated Holy Yoga teachers personally responsible for any liability. I recognize that any form of physical activity is a potentially hazardous one, and that they involve a risk of possible injury or even death. I hereby affirm that I am voluntarily participating in these activities with the knowledge of the risk involved. I agree to expressly assume and accept any and all risks of injury and/or death. I hereby affirm myself to be physically sound and suffering from no condition, aliment, impairment, disease, or other illness that would prevent my participation in Holy Yoga activities, I declare that I have disclosed any and all medical history to Holy Yoga and/or their affiliates relevant to participation. I hereby release Melanie Eccles or Monroe Free Methodist Church from any injury or risk involved in my participation of this yoga class.

Under 18 Waiver

By signing my name below, I hereby grant permission for my child to participate in this Holy Yoga Class. I understand that Melanie is *not* certified as a Holy Yoga Kids instructor and I give my permission for her to teach my child. I agree to register for the class and participate along with my child. I hereby release Melanie Eccles or Monroe Free Methodist Church or Holy Yoga Ministries from any injury or risk involved in my child's participation of this yoga class.

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