Enrolment

Kindly complete this Online Enrolment Form prior to attending The Yogi Tribe classes.

By completing this form you’ll assist us to work with your individual needs, so please answer to the best of your ability!

STUDENT DETAILS

Student Name

First Name

Last Name

Date of Birth

YYYY

Current Age

Gender

Student’s Street Address

City

Postcode

Parent/Caregiver’s Name

First Name

Last Name

Parent/Caregiver’s Contact Phone:

Parent/Caregiver’s Email Address:

Emergency Contact Name (other than Parent/Caregiver listed):

Emergency Contact Phone Number:

I give permission for The Yogi Tribe to send me any urgent updates via text message:

Yes

ABOUT YOU OR YOUR CHILD

What weekly class are you registering for?

Do you or your child have any medical issues?

(conditions, injuries, physical limitations, special needs, diagnosis or medication side effects) if not applicable please state N/A

What are your goals for you or your child within this Yoga programme?

(Strength, flexibility, balance, stress management, concentration/focus coordination, health concerns, boost self-esteem/confidence, other) Please explain other if applicable

I give my permission for Stacey and The Yogi Tribe to use my child’s image (photo or video) for online and print promotions of kids yoga and teaching seminars. My child will not be identified in any way.

Yes

The personal information collected on this form is in order to establish a client’s identity and to assist our teachers in providing the finest instruction and classroom environment for your child. All information will remain private and confidential. I, the parent or legal guardian of: NAME

First Name

Last Name

(A minor), understands that yoga includes physical movements, supportive touch, group work as well as an opportunity for relaxation, stress reduction, and relief of muscular tension. I declare that my child is physically able and ready to participate in the Yogi Tribes Program. I understand that The Yogi Tribe will take all reasonable care to ensure that the classes are safe. However, as is the care with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If my child experiences any pain or discomfort, my child will listen to his/her body, adjust the posture and ask for support from the teacher. Yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I affirm that I am alone responsible to decide whether my child practices yoga. I hereby agree to irrevocably release and waive The Yogi Tribe to any claims that I have now or hereafter may have against any and all Yogi Tribes Instructors. I have read and fully understand the above agreement terms and it is expressly agreed that Stacey Cox The Yogi Tribes and its agents and independent contractors shall not be held liable for claims, demands, injuries, damages, actions or causes of action, whatsoever, to my child or property arising out of or connected with the yoga program or due to a pre-existing condition not disclosed by myself or other persons responsible for my child. PARENT FULL NAME:

First Name

Last Name

Terms & Conditions

By filling in this form I agree to The Yogi Tribe Terms and Conditions

The Yogi Tribe has the goal to promote kids yoga within our community and city, therefore we use a website, social media accounts and paper/electronic advertisements to assist in achieving this goal. The above requested permission is to use images for this.
Thank you.

Let's book a class!