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REGISTRATION
FORM
For
Classes January
14th - March 3rd,
2012
(print and submit with payment)
Registration
is due prior to the meeting of the first class. Classes
may be cancelled due to insufficient enrollment. Class
size is limited. To avoid disappointment register early!
NO refunds after 1/21/12. The cost of a single class ($13)
and a $15 administrative fee will be deducted from your
refund. No phone or electronic registrations are accepted.
We do not confirm registrations. You can assume that your
registration was accepted unless you hear from us. Please
detach this form and send with your check to: Friendship
Yoga, 1231 Gilbert Court. Iowa City, IA 52240. No refunds
for missed classes or transfers to another session.
Name
________________________________________________________________
Address_______________________________________________________________
Parent's
Home Phone: _____________________ Work:________________________
Parent's
E-mail:________________________________________________________
Waiver
of Liability and Informed Consent
I acknowledge that it is my child’s duty to exercise
ordinary care for the protection of others and her/himself
while attending yoga class at Friendship Yoga. I assume
the risk of physical activity with his/her own physical
condition. I have received advice from my doctor that my
child is capable of physical exercise such as provided
by Friendship Yoga, or I will seek such advice, or I will
assume the risk of her/ he exercising without a doctor’s
examination.
I
take complete responsibility for my presence at the Friendship
Yoga Studio and I will not hold Nancy Footner, Jenn Bowen,
or any substitutes or Friendship Yoga Ltd. responsible
for any injuries or loss my child may incur as a result
of my participation in any yoga class or discipline now
or in the future.
I hereby
confirm that I have read and fully understand this release
of liability and assumption of risk agreement, fully understand
its terms, and sign it freely and voluntarily without inducement.
I also understand and agree to the refund policy.
Signature_____________________________________________Date_________
Parent’s/Guardian’s signature is
required.
Note:
in the event of a bad weather cancellation, we will
email you by 10 a.m. Saturday morning. If you don’t
hear from us, the class is “on”.
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