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Event / Class name (required)

Child name (required)

Gender (required)

Date of birth (required)

Address (required)

Name of parent 1 or guardian (required)

Phone number (required)

Your Email (required)

Name of parent 2 or guardian (optional)

Phone number (optional)

Your Email (optional)

Please provide details of any medical conditions, behavioural issues or religious beliefs that we should be aware of: (required)

Do we have permission to take group or individual photos of your child during yoga classes? These photos may be displayed in the centre, on Inner Child Yoga’s website and other promotional materials or on Inner Child Yoga’s social media:

I understand that my child undertakes this exercise program and use of all the facilities and equipment of Inner Child Yoga at their own risk. I hereby release the instructor of any loss, damage or injury caused either directly or indirectly by the application of these exercises. (required)

How did you hear about us?:

Payment Details:
Via credit card. Call Katie on 0405 585240.