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Main Menu
Home
Menu Toggle
Care Team
Physical Therapy
Yoga
Menu Toggle
Gentle Yoga
Gentle Yoga + Strength
Beginner Yoga
Pop-up Yoga Classes
Corporate Reset
Yoga Summer Camp
Lifestyle Medicine
Community
Education
Menu Toggle
pain course
stress management
Contact Us
Caregiver & ME Yoga Kids Registration Form
Please enable JavaScript in your browser to complete this form.
Caregiver Name
*
First
Last
Parent Name (if different from above caregiver)
First
Last
Child's Name (First and Last)
*
First
Last
Additional Child (children's names)
Grade child will start in the fall (list them in the same order as the children are listed above (e.g., K, 4, 2)
Parent Email
*
Parent Address
*
Parent Phone
*
(###) ###-###
Allergies? (list by participant name)
Behavioral issues or special concerns we should be aware of? (list by participant name)
Pricing
First Child -
$100.00
Second Child -
$50.00
Third Child -
$50.00
Fourth Child -
$50.00
Payment is due at first session. We will call you to confirm total and discuss your preferred form of payment (cash, check, credit card). Drop in rate $30.
Submit
Natalie is wonderful. She is knowledgeable, caring, and thoroughly invested in doing the best for her clients. I highly recommend her!
Cheryl Parrish
