ENROLMENT AND CONSENT FORM

Please fill this information for enrolment purposes.

KEY INFORMATION

This information is very important to us in order to get to know your child(ren) and deliver the best experience.

personal information

Parent/caregiver First Name

Address

Child's Name

Last Name

Phone

Child's DOB

Autism or behavioural difficulties?

Yes

Injuries or Medical conditions?

Yes

Does your child have any particular difficulties that you are hoping practising Yoga will assist with? (E.g. Problems sleeping, poor posture, stress, transition, etc…)

medical information

Medical practioner or service details:

Medicare card number

Private Health Cover:

Yes

Private health card number

Ambulance Cover

Yes

DO YOU GIVE US PERMISSION TO CALL A DOCTOR OR AN AMBULANCE IF NEEDED?

Yes

photographic/video and communication release

During the course of our sessions we take pictures, video images and sound recordings of the children and their learning. We would like to obtain your consent to use these pictures and recordings on our website, newsletter, in promotional materials and our social media platforms (Facebook, Instagram). We will never reference you or your child/ren by name or provide any specific information regarding you or your child on the publicly available platforms or publications. We will never sell these pictures; we will use them exclusively for TheYogaLeague's purposes.

I give consent for TheYogaLeague to take and use any photographs, video or sound recordings of my child/ren for the following purposes:

I acknowledge that I can withdraw my consent at any time by giving written notice to TheYogaLeague.

I accept terms & conditions: as a person who has lawful authority of myself or/and the child/ren referred to in this enrolment form. I confirm that me or/and my child/ren do not suffer from any chronic medical problems and I fully understand that it is my responsibility to inform TheYogaLeague of any injury, illness, infection, drug or condition, which could prevent me or/and my child/ren full participation in the program. I also understand as with any physical exercise injuries or accidents are possible. I have read and agree with the fees, payment structure and policies of TheYogaLeague. I understand there are no refunds for missed classes and missed classes can be made up at other classes throughout the term. Tuition fees are not refundable. Cancellations must be received 2 weeks prior to the start of the new term. I have read and understood all the conditions in this enrolment form, and when asked, have had explained relevant information about the services offered by TheYogaLeague. I declare the information in this enrolment form is true and correct and endeavour to immediately inform TheYogaLeague in the event of any change to this information.

Your Signature

Date

or Initials.

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