Yoga Barn Summer 2024
Registration for Yoga Barn programs - SUMMER 2024
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电子邮件地址 *
Parent/Guardian Name *
Parent/Guardian Email *
Parent/Guardian Cell Phone *
Emergency Contact Name + Phone *
Are either of the child's parent/guardians a teacher or first responder?
Teachers/first responders receive 10% off enrollment.
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Total number of campers you want to register:
Siblings after the first child receive 10% off enrollment fee.
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必填
Select Date(s) to Attend:
*Cancellation Policy: We require a 20% deposit to hold a spot for your child. In the case of low enrollment, a particular week may be cancelled, but we will do our best to let you know ASAP and provide a full refund if that should occur. Cancellations on your part will incur a 20% nonrefundable fee (your deposit).
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必填
Camper #1 Name *
Camper #1 Date of Birth *
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Camper #2 Name
Camper #2 Date of Birth
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Camper #3 Name
Camper #3 Date of Birth
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Liability Waiver / Photo Release

I, the participant and/or parent/guardian of minor participant(s), recognize the possibility of physical injury associated with the activities at Madison Yoga Barn (Mindfully Instructive, LLC). I hereby release, discharge, and/or otherwise indemnify Mindfully Instructive, LLC and all personnel against claims by or on behalf of the registrants as a result of the registrant's participation in Madison Yoga Barn/Mindfully Instructive, LLC's programs. I also acknowledge that I freely choose for my child to attend the Madison Yoga Barn's program, and I understand that Mindfully Instructive has taken all precautions to protect parents, students, and staff from exposure to COVID-19. I accept full responsibility for all medical expenses for any injuries or exposure I, or my child, might receive by reason of my or my child's attendance. Mindfully Instructive, LLC likes to include photos of the students in our programs on our printed materials, website/blog, and social media accounts. We will not identify any individual students by name (unless specifically and separately authorized). By clicking "Yes" on this form, you are providing us with a digital signature and agreeing to the terms and conditions outlined in this form.
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必填
Payment Options
Select how you would like to submit payment.
20% deposit due at registration. Without deposit, your spot will not be held.
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必填
Deposit Details
For Venmo/Paypal deposits - list Venmo handle or Paypal email address here. If paying by check, write "check." Without deposit, your spot will not be held.
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