Yoga Child Registration Form for childrens' workshops and Camp programs:

Please return at least one week prior to start date with payment in full. Please Mail to :

Yoga Child

PO Box 63730

Phila PA 19147

1. Childs Name and age:

2. Parent Name:

3. Parent Phone:

4. Address:

5. Email:

6. Emergency Contact: Name & phone number

7. Please indicate the workshop or camp program for which you are enrolling and the total amount due.

Program:

Date or Dates:

Time:

Amount due:

8. Please indicate if your child has any special needs

9. Please indicate if your child has any food allergies or other allergies. For some programs and workshops we will be providing a light snack. If you prefer to send your child with his/her own snack, that is fine.

You will receive a call from us confirming receipt of your registration form.

Our devoted yoga staff looks forward to sharing yoga with you and your family.

10. Please sign your full name here:

____________________________________________________________

11. Today's date:_______________________