New Student Information Sheet

Weekly Class Schedule:

Saturdays 9-10AM

at

Armor Brewing Co.

(scroll to complete the waiver...)

Have you previously completed a waiver for Divine Alignment Yoga?*

Yes, for myselfYes, for myself and my childNo, it's my first time completing a waiver

Who are you completing this waiver for?*

(If you have multiple children attending a Mommy and Me class, please list all the children attending below.)

Name*

First NameLast Name

Parent/Guardian Name

First NameLast Name

Children's Information*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Would you like to be included in our email communications?*

YesNo

Mobile Phone*

Please enter a valid phone number.

May we communicate with you via text message?*

YesNo

Date of Birth*

Date

Have you ever participated in yoga?*

YesNo

If Yes, when and how often?

Do you have any medical restrictions or conditions?

YesNo

If yes, please explain?

What are you looking for from yoga?

How did you hear about Divine Alignment Yoga?

Did a friend refer you? Help them earn a discount!

Type your friends name here.

Holy Yoga Activity Disclaimer*

Holy Yoga Child Activity Disclaimer*

Signature*

Choose a yoga class:*

Yoga Adult @ Armor Brewing Co.Saturdays @9AM // 9 Prestige Cir, Allen, TX 75002

$20.00 Quantity

CASH PAYSelect this option if you are paying with cash. ***Discount codes do not apply to cash payments.***

$ Free Quantity

Yoga Child(Child age 4+)

$10.00 Quantity

Enter coupon

Total

$0.00

Credit Card

Payment is processed securely through Square.

*Kindly keep in mind that the purchase of in-person classes are non-refundable. However, they are fully transferable and can be used for future classes within our schedule.

***To recieve coupon codes for discounts on classes, follow @divinealignment_yoga on instagram.