Teen's Yoga Health Questionnaire

Parent's Name*

First Last

Parent's Email*

Parent's Mobile Phone*

Child's Name*

First Last

Child's Age*

Does your child have any of the following?

Please give details about the conditions above (if applicable)

Please give details of any illnesses, conditions, disabilities or injuries that your child has (if applicable)

Please give details of any allergies that your child has (if applicable)

Please give any additional information that you would like us to know about your child (if applicable)

Please tick here if you give permission for your child to feature in photographs taken during the class. These photos will be used only by Felicity Wood Yoga for promotional purposes (e.g. social media).

Please read the following and confirm*

I confirm that, to the best of my knowledge, these answers are accurate and I know of no reason why my child should not participate in a yoga class. I acknowledge that all physical activities involve risk of personal injury. I understand that the teacher may adjust the position of my child whilst in a yoga pose to ensure safety at all times. I understand that classes are non-refundable when missed. I am aware however that I can send a friend if I know that my child is going to be away.

Please tick here if you would like to subscribe to our e-newsletter to receive details about our classes, workshops and retreats