Account Registration for Yoga + Mindfulness Classes: Use the form below to create an account with Sol & Skye All your information will be saved to make registering for classes, camps and events much easier! Please create an account for your child (children) by filling out the information below.RM_StatsSol & Skye Student Account Email *Password *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long. Adult Student Information: * For the Family or Toddler Yoga Classes, please list all participating below. All other Youth Yoga Classes please continue to next section. Adult Participant 1 (First and Last Name):Adult Participant 2 (First and Last Name):Adult Participant 1: Any allergies or medications?Adult Participant 2: Any allergies or medications? *Adult Participant 1: Do you require any special accommodations? Any physical or mental health challenges that I should be aware of?Adult Participant 2: Do you require any special accommodations? Any physical or mental health challenges that I should be aware of? *Youth Student Information: Youth One (First and Last Name): *Date of Birth: *Child's Primary Care Doctor (First and Last Name): *Child's Primary Care Doctor - Phone Number: *Child's Primary Care Doctor - Address: * Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Any allergies or medications? *Does your child require any special accommodations? Any physical or mental health challenges that I should be aware of? *Youth Two (First and Last Name):Date of Birth:Child's Primary Care Doctor (First and Last Name):Child's Primary Care Doctor - Phone Number:Child's Primary Care Doctor - Address: Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Any allergies or medications?Does your child require any special accommodations? Any physical or mental health challenges that I should be aware of?Youth Three (First and Last Name):Date of Birth:Child's Primary Care Doctor (First and Last Name):Child's Primary Care Doctor - Phone Number:Child's Primary Care Doctor - Address: Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Any allergies or medications?Does your child require any special accommodations? Any physical or mental health challenges that I should be aware of? Parent or Guardian Info: Primary Contact 1: First Name *Last Name *Primary Contact 1: Phone *Primary Contact 1 (email): *Primary Contact 1 - Address (Street Address, City, State, Zip Code): * Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Primary Contact 2: First Name *Last Name *Primary Contact 2: Phone *Primary Contact 2 (email): *Primary Contact 2 - Address (Street Address, City, State, Zip Code): Address Line 1 Address Line 2 City State or Region Alabama Alaska Arizona Arkansas Armed Forces America Armed Forces Europe Armed Forces Pacific California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State or Region Country Zip Emergency Contact - First and Last Name: - this person will be contacted if neither one of the primary contacts can be reached *Emergency Contact Phone: *Emergency Contact Email: *Which phone # and email do you prefer to receive updates from? * Primary Contact 1 Primary Contact 2 Both Please list all additional people authorized to pick up your child(ren): (First + Last Name, Phone Number) *Any additional concerns, goals, comments, or questions you wish to share: Legal: As a parent or legal guardian or as an adult student, I do hereby release and discharge Sol & Skye as follows in consideration of the services to be provided by Sol & Skye, LLC, and its Teachers/Instructors (collectively, “Sol & Skye”): I understand that yoga involves stretching, balancing, and strengthening by moving through different yoga postures and creative movements. I acknowledge that yoga is an activity that involves physical movements and opportunities for relaxation, stress reduction, and relief of muscular tension. I understand that, as is the case with any physical activity, the risk of physical injury, whether minor, serious, and/or disabling or causing death, cannot be entirely eliminated. I know of no physical or mental condition that would prevent my child or myself from participating in yoga activities, exercises, or instruction. I will inform the instructor of any health or mental conditions that may prevent my child or myself from safe participation in yoga. Yoga is not a substitute for medical attention, examination, diagnosis or treatment. I understand that I alone am responsible for keeping the instructor informed of my child’s and my health needs and deciding if he/she/I should practice yoga. I understand that the instructor may provide gentle, hands-on adjustments or comforting touch and by signing this waiver I give my informed consent to these assists. By signing this waiver I give permission to the instructor to share Yoga based philosophies, Sanskrit, and mudras (hand postures) associated with the practice of yoga (ie. Namaste). Sol & Skye occasionally takes pictures of children during their programs and events. Please indicate below if you wish to give Sol & Skye permission to use photographs or videos of you or your child for promotional purposes. * I do give permission I do not give permission I have fully and carefully read this Release of Liability Waiver and Media Release Form. I hereby voluntarily and expressly release Sol & Skye from any and all liabilities, claims, demands, rights or rights of action I may have, now or in the future, which is or may be related to or arise out of, either directly or indirectly: (i) myself/my child’s participation in yoga instruction; or (2) any omissions, acts, or negligence of any sort of Sol & Skye. By signing this form, I declare that I am the parent / legal guardian of the minor child identified in this form and I am authorized to grant such permission. Please sign/type name below * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
