Sign-Up Form - Mind Over Matter Yoga
Thank you for your interest in our children's yoga classes. Please complete the form below for our information.
We will not share the information on this form with anyone else and all information will be kept confidential.

Next half term’s adventures will be a five week block running consecutively from Thursday 7th November, to Thursday 5th December. The class will take place 4-5pm at St Chad's Centre, Bishops Tachbrook as usual.

The cost of the block of classes is £32.50 per child. You can pay via Paypal on this link https://www.paypal.me/nikkiannefrancis or via bank transfer. (Please email me for bank details) Nikki@takeitfrommummy.com

Please make sure you click 'submit' at the end of this form to ensure we get all your details and booking info.
Please note that your booking is not secured until your payment has been made.

Due to the nature of these block bookings i am unable to offer refunds.

Please make sure you click 'submit' at the end of this form to ensure we get all your details and booking info.
Please note that your booking is not secured until your payment has been made.

Due to the nature of these block bookings i am unable to offer refunds.

Many Thanks.
Name and gender of child attending *
Your answer
Date Of Birth and age of Child *
Your answer
Address *
Your answer
Parents Contact Information
Your name *
Your answer
Phone number *
Your answer
E-mail *
Your answer
Emergency Contact - (not yourself) name and phone number please. *
Your answer
Does your child have any allergies or medical conditions? If yes, please specify and include any medication required. *
Your answer
Please tell us here if there's anything specific you'd like us to know about your child.
Your answer
From time to time we might take a photo for use on our social media or on promotional material. This might not be often as our focus will be on the class of course. Are you happy for your child to be in any such photo? *
Please tick below to confirm that you will stay on site during the class. *
Required
Name and gender of child attending *
Your answer
Date Of Birth and age of Child *
Your answer
Address *
Your answer
Parents Contact Information
Your name *
Your answer
Phone number *
Your answer
E-mail *
Your answer
Emergency Contact - (not yourself) name and phone number please. *
Your answer
Does your child have any allergies or medical conditions? If yes, please specify and include any medication required. *
Your answer
Please tell us here if there's anything specific you'd like us to know about your child.
Your answer
From time to time we might take a photo for use on our social media or on promotional material. This might not be often as our focus will be on the class of course. Are you happy for your child to be in any such photo? *
Please tick below to confirm that you will stay on site during the class. *
Required
Submit
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