Yoga & Meditation Registration For Children

Did the Child have any major surgery in the last six months? *
YesNo
Please indicate below if currently or previously have had any ailments.
Please give details of the nature and duration of the condition and if currently undergoing any treatment:

Parent's Full Name
Phone
Email
Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Attended any program by Isha Foundation ?
YesNo
HTML
Name of the Isha Program you have attended Please fill this incase you answered yes to above question
What do you want to derive out of this workshop for your child ?
Comments if any
Confirmation I hereby willingly undertake to have my child attend this program completely. I take full responsibility for the result and indemnify the organizers against all claims and suits. I will not communicate the contents of the program, either directly or indirectly to anyone else. I understand the participation guidelines and agree to follow them. I hereby declare that the above information is true, accurate and complete to the best of my knowledge.
Name of Parent
Email
Date

Kids Registration