Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Parent Child Yoga Dates *Saturday January 18th 12:00pm-1:00pmSaturday January 25th 12:00pm-1:00pmEnjoy some time to connect with your child. Slow down your busy life style together, join hands, and hearts, using your mind, body, and soul. Enter the studio with PEACE leaving you with LOVE and beautiful conversation. Healing each other one breath at a timeParent / Legal Guardian Name *FirstLastParent Email *AddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodePhone (Cell) (parent / legal guardian) *Emergency Contact Name & NumberName & Age of Child *Please share any allergies and all additional health conditions/concerns or medical history related to your child that would be important for us to know.Pay by Credit CardSingle ItemPrice: $30.00OR E-TRANSFER PAYMENT OPTIONCheck this box to confirm that you will send an e-transfer for the total shown below upon registering & submitting this form.Email: lovechild.breathe@gmail.com (we have auto-deposit enabled) **IMPORTANT**: In the notes of the e-transfer please specify your children's name and specific program (Ex: Little Seedling).Consent & Waiver Information (mandatory to read)I understand that, Love Child Connected does not assume responsibility for any injuries or accidents sustained during participants attendance in the wellness studio. I am aware that this practice is safe but there is an element of risk. While Love child connected participants and facilitators take reasonable precautions to minimize these risks, this is no guarantee against injury or loss. Some of the risks associated with these types of activities include (but are not limited to): scrapes, cuts or bruises; sprains, strains or possible broken bones; illness from known or unknown sources; theft or loss of possessions; and unforeseen injuries from activities, equipment or actions of your child, other participants or other people, including negligent actions. Although it is unlikely, the potential also exists for debilitating injury, long-term incapacity and death.Your child will be following Love child connected Safe and well-being guide which outlines safety management practices. You are welcome and encouraged to review this document. A copy of safe and well-being guide is available from www.lovechildconnected.ca.Participants are expected to conduct themselves in a safe manner and to abide by the Love Child Connected safe and well-being guide. Anyone who does not or whose actions jeopardize their safety or the safety of the group will be dealt with immediately. If appropriate, participant may be sent home at the expense of parents/guardians.I understand that Love Child Connected Wellness Studio for Kids and website are not an attempt to practise medicine or give specific medical advice. The information and programs/activities and games are for the sole purpose of being informative and is not to be considered a substitute of professional medical advice of anyone(s) diagnosis, or treatment. Always seek the advice of your professional or qualified mental health provider with any concerns you may have regarding anyone(s) condition or/and if you believe you or another individual is suffering a mental health crisis or medical emergency seek medical attention immediately or dial 911.Please read the above consent/waiver form. *Checking this box indicated that I have read and agree to the above Consent and Waiver information/form and have signed below to verify that.I have already signed LoveChild waiver for my child previously.Please Sign / type your Full NameI would like to sign up for newsletters/upcoming events/classes and coupons.Yes, Please !No, Thank youSubmit & Register