Yoga for Kids/Teens, Release/Registration Form
In consideration of being permitted to participate in Hatha Yoga activities, I, for myself, my heirs, legal representatives, and assigns, do hereby release said activity, the activity instructor, Disha Gala, and any other person responsible for organizing and/or overseeing the activity at the location where the said activity will be conducted, from all suits, claims or demands of any kind, which may result from any injury, loss or damage of any kind, arising out of or in connection with my or my child's participation in the said activity.

Please fill out as much information as possible in all the fields below. More detailed information will help us guide you better in your yoga practice.
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Child's Full Name (First Last) *
Child's date of birth
Father's name (first last)
Mother's name (first last)
Home/Mobile Phone
Email address *
Will you be attending in person or online?
*
Place of residence (city, state, country)
Name of school/grade
What benefits do you expect to realize from your yoga practice?
Previous Yoga Experience - Style, Duration etc
Any other sporting or physical activity that you participate in
Any medical condition that we should know about (include past surgeries)
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