Yoga for Life
A  lifestyle for families and children
 
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Write checks out to the Danville Yoga Center
and bring with you to class on the first day of the session
New Student Information

Please complete all required fields.  You only need to complete this form once or you can resubmit again when your information has changed. 

Child's First Name: *
Child's Last Name: *
Birthday: *
Age: *
School Name:
Parent's Name: *
Address Street: *
City: *
State: *
Zip Code: *
Day Phone: *
Evening Phone: *
Cell Phone:
Email Address: *
Emergency Name &     Phone #
Please list some of the desired benefits/outcomes from your child participating in this YogaKids class:
Please list all current or past health challenges/injuries   /operations/diagnoses:
Please share any information that you think might be helpful for me to know in order to create the most positive experience for your child:
How did you hear about this YogaKids class?: *



Registration Form

Please submit one form per child.  Once I have received your form, I will confirm registration back to you through email.  Thanks!
Child's Name: *
Birthday: *
Age: *
Session: *
Parent Name:
 *
Address Street:
 *
City: *
Zip Code: * (5 digits)
State: *
Daytime Phone: *
Evening Phone: *
Cell Phone:: *
Email: *
Comments:


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