Manly West State School After School Yoga Class Registration

🌿 After-School Yoga Class

Manly West S.S - Registration Form — Term 2
Give your child the gift of calm, connection, and movement.

Our weekly after-school yoga sessions are a beautiful way for children to unwind after a busy school day. Through playful movement, breathing exercises, and relaxation techniques, kids will learn to listen to their bodies, manage big emotions, and build confidence, all while having fun!

These sessions are designed to be gentle, inclusive, and nurturing, helping children develop strength, flexibility, and mindfulness in a supportive environment.

No experience needed, just a curious heart and a willingness to move!
When: Every Wednesday from 3pm to 4pm

Where: Manly West State School Hall

Term 2 Classes Dates:

Wednesday 7th May

Wednesday 14th May

Wednesday 21st May

Wednesday 28th May

Wednesday 4th June

Wednesday 11th June

Wednesday 18th June

Wednesday 25th June

✨ Please note: Prep students must be collected promptly at 4:00 pm.
🧘‍♀️ Student 1 - Full Name*

First NameLast Name
🧘‍♀️ Student 1 - Date Of Birth*

MonthDayYear
🧘‍♀️ Student 1 - Grade/Class*
🧘‍♀️ Student 2 - Full Name*

First NameLast Name
🧘‍♀️ Student 2 - Date Of Birth*

MonthDayYear
🧘‍♀️ Student 2 - Grade/Class*
👩‍👧 Parent/Guardian's Full Name*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number
Contact Email Address*
example@example.com
Emergency Contact (if different):
Full Name
Phone number
Child's Health & Safety Information:*

Allergies (e.g., food, environmental)Medical conditionsPhysical limitationsAny specific needs or accommodationsNoneOther
Is there any relevant information we should be aware of regarding your child (e.g., allergies, medical conditions, or special requirements)?
Do you give permission to take photos of your child during the classes for use in the school newsletter and website?*

Yes, I give permissionNo, I do not give permission
Release and Waiver of Liability:

In consideration of permitting my child to participate in kids' yoga classes provided by Culture of Wellness (Instructor: Cindy Brugier), I, the undersigned parent/guardian, hereby:

Release and Discharge: Release and discharge Culture of Wellness, Cindy Brugier, and any associated instructors, employees, agents, or representatives from any and all claims, liabilities, damages, or expenses, including but not limited to personal injury, property damage, or loss arising directly or indirectly from my child’s participation in the yoga classes.

Indemnification: Agree to indemnify and hold harmless Culture of Wellness and Cindy Brugier from any claims, actions, or demands brought by or on behalf of my child, or arising from my child’s actions during or in connection with the yoga classes.

Acknowledgment of Risk: Acknowledge and understand that participation in kids yoga classes involves certain risks and hazards. These risks may include, but are not limited to, physical injury, falls, strains, sprains, and other unforeseen accidents. I voluntarily assume all such risks on behalf of my child.
Date*

MonthDayYear
Date
Signature*

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📌 Please Note
- PREP children must be collected promptly at 4:00 pm.
- Spaces are limited and allocated on a first-come, first-served basis.
- There is no lock-in for the year — we operate term by term.
- You will receive an email with a new registration form at the end of each term if you wish to continue.
- Missed a class? One make-up session can be offered if a class is missed due to illness or unforeseen events. Please notify us in advance when possible.
We look forward to seeing your child on the mat soon!
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🌿 After-School Yoga Class