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Registration Form
Guardian name:
(Required)
Guardian Phone:
(Required)
Guardian Email:
(Required)
Guardian Address:
(Required)
Street Address
Address Line 2
City
ZIP Code
Child Name
(Required)
Child Date of Birth:
(Required)
MM slash DD slash YYYY
Child Age:
(Required)
Any special circumstances I need to be aware of Is the child potty trained? If not, an adult will need to be reached in case they need changed during class.
Media release:
I
Guardian name
(Required)
give permission for my child,
Child Name
(Required)
to be photographed.
Do you authorize TheLittleYogi to use the photos/videos?
I authorize
I do not authorize
Check what you agree with photo/video can be used:
In class
On social media
On website
For advertising
