Laugh Time With Flora - Registration Form

Laugh Time With Flora - Summer Term Registration & Liability Release Form

Fill out the form carefully for registration
Participant Name *

First Name Last Name
Participant (or Participant Guardian's) E-mail
Mobile Number

Area Code Phone Number
Summer term will run from 13 April to 27 June.

Term divides into two halves, both 5 weeks long, with a week long half term break from 17-23 May.

The Summer term schedule comprises: 30-minute online classes on Zoom three times a week and IG & FB Live once a week, and a new 45-minute socially distanced 'Park Laugh' class which will pilot on 17 April and run on an ad hoc basis (probably fortnightly to monthly).
Which Summer term class(es) would you like to join?

Tickle Me Tuesday 09:30-10:00 BST (Zoom) Hump Wednesday Pick Me Up 18:30-19:00 BST (IG & FB Live) Saturday Laugh It Out 18:00-18:30 BST (Zoom) See Off The Sunday Blues 17:00-17:30 BST (Zoom) A mixture of online classes Saturday Park Laugh, Victoria Park, 17 April 10:30 - 11:15 BST
What kind of class booking would you like to make?

Free first online class Single online class: £7 / £5 concession Block of 5 online classes / half a term: £30 / £23 (equivalent to £6 / £4.60 per class) Block of 10 online classes / full term: £50 / £40 (equivalent to £5 / £4 per class) Single Park Laugh class (17 April): £9 / £7 concession Pay What You Want amount - if the price of classes is an access barrier for you, please select this payment option + indicate what class booking you want to make from the options listed above
Laughter Yoga Disclaimer

Laughter Yoga™ has many benefits for your mental and physical wellbeing. During laughter we release endorphins which are the feel-good hormone that uplift our mood and help to combat stress. This release of hormones also boosts our immune system. Laughter Yoga™ is based on the scientific fact that our brains do not greatly distinguish between real and fake laughter - so even if you don't feel like laughing to begin with, you can still reap many benefits from this session.

Laughter Yoga™ is not a substitute for proper medical consultation for physical, mental and psychological illnesses and may not be suitable for everyone.

It is CONTRA-INDICATED for people suffering from uncontrolled high blood pressure, heart disease, epilepsy, any kind of hernia, severe backache and major psychiatric disorders. Pregnant people with previous history of miscarriages and also those who are in advanced stage of pregnancy should take medical advice from specialists before doing laughter exercises.

This list is for guidance only and is not meant to be exhaustive. If in doubt do not try it and consult your trained medical professional for guidance.

Anyone experiencing discomfort while laughing should stop and seek expert medical help. Please use your common sense: no strain, no new pain.

The Dr Kataria School Of Laughter Yoga™ decline any responsibility from incidents resulting from the use (or mis-use) of the Laughter Yoga™ technique. By taking part in a Laughter Yoga session you accept full responsibility for your physical fitness and state that you are able to participate safely to the activity. You are strongly encouraged not to participate in or stop participating in activities you feel uncomfortable with.
By registering and booking with LAUGH TIME WITH FLORA, I confirm that:

I agree to follow Flora's instructions and understand that my wellbeing is my responsibility and that I participate in classes at my own risk I will have a working webcam during Zoom classes so that Flora is able to see me clearly and offer suitable guidance I understand that it is my responsibility to consult with a qualified medical practitioner before joining a class should I have any doubts about my ability to safely participate
What is your date of birth?

Month Day Year
Date
Emergency contact: name and telephone number
Do you have any ongoing medical conditions, or history of significant accident, injury or trauma you would like Flora to be aware of?

0/500
Are you prescribed an inhaler? If yes, please have it with you during sessions.

Yes No
Do you have any experience of Laughter Yoga?

I am a complete beginner I have attended some Laughter Yoga classes before I have a regular Laughter Yoga practice I exercise/do sports but have never attended a Laughter Yoga class before
Anything else you would like Flora to know?
Would you like to be added to the LAUGH TIME mailing list so you can be the first to hear about upcoming classes and courses?

Yes No
Confirm & Submit

Pressing 'Confirm & Submit Registration' below indicates that you have read and agree to the terms and conditions stated above and fully release the Laughter Yoga teacher whose classes you are attending from any form of liability.

What happens next?

After submitting this form you will be sent an email with payment options (Paypal, Revolut, bank transfer) and participation information.

Please make your payment in advance to secure your place.

Thank you for registering.

Looking forward to laughing with you!
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Laugh Time With Flora - Summer Term Registration & Liability Release Form