Little Buddha Jewel Meditation and Buddhism classes
** Eligibility: Open exclusively to BJM students and their family members and friends.**
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Email *
Name of the Child *
Date of Birth of the Child *
Gender of the Child *
Name of the Parent/Guardian *
Relationship with the Child *
Required
Contact Phone 
 *
Contact Email
 *
Home Address
Please check all that apply to describe the physical condition of the child *
Emergency Contact Name and Relationship with the Child *
Emergency Contact Phone *
What do you hope for your child to learn from this class?
Introduced by / Relationship

Please be mindful of, and adhere to, the following guidelines. This is to provide a safe and secure environment for everyone to enjoy the class and promote an ideal environment to practice. By checking boxes below, you are agreeing to follow these guidelines.

 *
Yes, I agree to follow.
To provide and ensure a safe environment for all participants, parents/guardians are requested to keep child(ren) at home when they have fever, nausea, or other contagious diseases. If a child becomes ill while in class, parents/guardians will be requested to pick up their child (ren).
If there are any health conditions (such as illnesses and allergies) of which we should be aware, it is the legal obligation of the parent/guardian to disclose such information to us.
In the case of illness, accidents and injuries, which may result from the participant's voluntary participation in the classes, Buddha Jewel Monastery and its volunteers and staff are not responsible for any and all liability or damages. It is the duty of the parent/guardian to provide primary accident and medical insurance for the child.
Please wear comfy and modest clothes for meditation. Long pants and socks help keep you warm while sitting. Try not to wear shorts, tank tops, or anything too tight so you can move and sit comfortably.
Do you give permission for your child’s photo to be taken during class activities and for documentation purposes only by Buddha Jewel Monastery? *
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