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JuvoLiving
Street Address
Coham, Surrey
07725 087653
Life Enhancing Yoga & Project Management with Laura Ebeid
Your Custom Text Here
JuvoLiving
Home
About
Contact/Location
Sign In
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RKS New Student Registration Form
Child Name
*
First Name
Last Name
Year Group - Please select from drop down
*
Yr 3
Yr 4
Yr 5
Yr 6
Yr 1
Yr 2
Yr R
Parent Name
First Name
Last Name
Email Address
*
Contact Number
*
What do you hope that your child will gain from your classes with me?
Does your child have any medical conditions I need to be aware of?
*
Does your have any injuries current/past I need to know about? If yes, please provide details below.
*
New student waiver
*
Please read and click the 'agree' box before your child comes to class: By signing below, I acknowledge that yoga is a physical discipline that requires a certain amount of mental concentration and physical strength and endurance. I agree that my child will work according to his/her limitations; take full responsibility for his/her safety and well-being; and release Laura Ebeid from any liability associated with her yoga instruction. Furthermore, I acknowledge that my son/daughters participation in yoga classes exposes him/her to a possible risk of personal injury. I am fully aware of this risk and hereby release Laura Ebeid from any and all liability, negligence, or other claims, arising from, or in any way connected, with my son/daughters participation in yoga. My signature further acknowledges that I shall not now, or at any time in the future, bring any legal action against Laura Ebeid; and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns. My signature verifies that my son/daughter is physically fit to participate in yoga classes and where appropriate a licensed medical doctor has verified his/her physical condition(s) and/or injuries for participation in this type of class. My signature is binding to this liability waiver from this day forth.
I agree
Thank you!