JHUMBLE Fall 2025 Registration Form

JHUMBLE Registration Winter - Spring 2025

JEDI HIP HOP TUMBLE with Michál Anna Carrillo at NICE DAY YOGA
Student Information

Personal & Health & Contact
Name

First NameLast Name
Birth Date

MonthDayYear
Age (at time of classes)
Grade
T-shirt Size:
List Any Allergies and Dietary Restrictions
Any Medical needs?
Parent / Guardian Information

(All correspondence and and invoices will be sent to this person)
Name

First NameLast Name
Name

First NameLast Name
Email
example@example.com
Email
example@example.com
Mom Cell Phone if applicable

Area CodePhone Number
Dad Cell Phone if applicable

Area CodePhone Number
If not a parent, what is relationship? if applicable
Emergency Contacts and Authorized Pick Up Persons
Emergency Contacts and Authorized Pick Up Persons
In case of emergency and unavaliability of parent, do we have your permission to go to hospital if needed?
Program Tuition $130 per student (includes t-shirt)

Please bring cash in person first class or utilize venmo: @livinglighthawaii If you need a different arrangement, please reach out directly to Michál at: 808 987-4243
Payment Type
Terms & Conditions

I agree to have my child regularly & promptly attend class, ready to learn, in proper attire and properly fed. If my child cannot attend I will text Michál. I agree to be a proactive part of upholding the JHUMBLE CREED for/with my child and self. :)
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Signature
Should be Empty:

JHUMBLE Registration Winter - Spring 2025