Registration FormPlease submit the form below before the first day of class! Registration Thank you for your interest in our Kids Summer Yoga & Gardening Program! Limited space is available, registration is first come, first served. Please complete the form once for each child and each session you intend to sign up for. This form serves as a planning tool for In Bloom KYG. Once your form is submitted and deposit of $112.50 (half of session fee going towards the full price) is paid, your child's seat(s) is secure. A confirmation email will be sent to your primary caregiver email. For questions please email inbloomkidsyoga@gmail.com. We will do our best to respond with in 24 hours. Child's First, Last Name and preferred pronouns if any * First Name Last Name Date of Birth * MM DD YYYY Child's home address * Address 1 Address 2 City State/Province Zip/Postal Code Country Primary Caregiver's Name * First Name Last Name Primary Caregiver's email * Primary Caregiver's phone * (###) ### #### Primary caregiver #2 name First Name Last Name Primary caregiver #2 email Primary caregiver#2 phone (###) ### #### Emergency Contact name * First Name Last Name Emergency Contact Phone * (###) ### #### Emergency Contact #2 name First Name Last Name Emergency Contact #2 phone (###) ### #### Check the sessions you are applying for to help us organize better. *Reminder that a registration form must be filled out for each session. If your child would like to attend more than one session you must fill out the form for that session. *Thank you * Wings in our World July 1-3 Sun & Moon July 8-10 Soil, Rain & Clouds July 15-17 The Rainbow in our Body July 29-30 Heart & Harmony August 12-14 Our Musical Earth August 19-21 Consent, Liability Release and Photography Agreement Please read and give consent: I, individually and as parent/guardian of the minor(s) identified above, hereby acknowledge the following notices and grant In Bloom Kids Yoga & Gardening, Seattle Park and Rec and City of Seattle P-Patch and their host studios the following Liability Release: I acknowledge and fully understand that my child and I will be engaging in physical activities that may involve some risk of injury. I acknowledge that I have been advised to consult with my and my child's physician with respect to any past or present injury, illness, health problem or any other condition or medication that may affect our participation in the In Bloom KYG program, class, workshop or sessions. I assume the foregoing risks and accept personal responsibility for any personal injury sustained by myself or my child and discharge and hold harmless In Bloom KYG and SPR, City of Seattle P-Patch and their host studios from any claim, cause of action or liability for damages arising from any personal injury to my child or other persons or property caused by my or my child’s participation in the In Bloom KYG program, class, workshop or sessions. Photographs: I acknowledge that my child and I may be photographed during In Bloom KYG classes and these photographs, which shall be owned by In Bloom KYG, may appear in In Bloom KYG promotional materials unless otherwise specified. No person whose photograph is used will be identified by name, nor will any compensation be extended for such use. I have read the Consent, Liability Release and Photography Agreement. Yes, I give consent. Thank you for submitting the registration form. If you have any questions, please contact inbloomkidsyoga@gmail.com.
