Enrolment Form

Term 3 2026 (10 week Term)

15th July- 16th September

WEDNESDAYS

10.30am-11.15am

Kangaroo Ground Community Hall

3 Ness Lane, Kangaroo Ground

BYO YOGA MAT & BLANKET FOR YOUR BABY TO LIE ON. PRAMS, CAPSULES, BABY WEARING & BOUNCERS WELCOME. QUIET TOYS & A SNACK FOR OLDER CHILDREN IS RECOMMENDED. THERE IS ALSO AN OUTDOOR ENCLOSED PLAY AREA.

Your Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Your E-mail

example@example.com

Babies/Children's names & ages if attending with you. Write N/A if you are pregnant

Which class are you enrolling in:

If you are pregnant, how many weeks are you? We advise 13 weeks (second trimester) minimum and a GP or health professional clearance is recommended. Write N/A if this does not apply.

If you are post partum, how many weeks ago did you have your baby? We advise 6 weeks minimum post birth and a GP or health professional clearance to return to exercise or begin any new exercise. Write N/A if this does not apply.

Did you experience any pregnancy or post birth complications that may affect your yoga practice? If YES please specify below, if not write NO

Do you experience any of the following?

If you selected 'other' or have more than one concern above please specify

Does your child/children have any medical conditions that may effect their ability to join in with baby yoga/baby massage? If YES please describe below.

Emergency contact NAME & PHONE NUMBER

What do you hope to get out of the class?

If you selected 'other' or have more than one answer above please specify

How did you hear about us?

Unfortunately, classes are NOT eligible for refunds if you cannot make it along on the day.

Please select your preferred enrolment option below. Please note Term 3 is made up of 10 classes/weeks. If you are signing up as a full term enrolment during term classes will be pro rata as to how many classes remain at $20 each. Class passes can be used any time during the term and do not have to be used in consecutive weeks.

Please make payment via direct bank deposit on completion of this form. Your place is not secure until payment is made.

Once payment is made email a screen shot or payment receipt to:

littlelunaryoga@gmail.com

Bank Details:

Name- Little Lunar Yoga

BSB-013333

A/C-1551 70936

REF-YOUR FULL NAME MAMA MINI T3

A welcome email will be sent once payment is received and before your first class.

Thank you

Lauren

I agree to adjust my practice according to my limitations to ensure no personal injury occurs. I agree to inform the teacher BEFORE class of any recent injury or change to my physical condition. I hereby declare that I release Little Lunar Yoga of any responsibility for any injury sustained and that I will take full responsibility for myself and my baby/child during the classes.