Registration Please fill out the form below. If you have already registered and would like to make a secure payment, click here. Child Name 1 Child Name 2 Child Name 3 Child Name 4 Grade ---Pre-SchoolKindergarten1st2nd3rd4th5th School ---Bet Yeladim (Columbia)Bushy Park ElementaryCelebree (Fallston)Childtime Learning Center (Columbia)Clarksville ElementaryColumbia AcademyCradlerock ElementaryElkridge ElementaryGorman Crossing ElementaryIlchester ElementaryKiddie Academy Childcare (Elkridge)La Petite Academy (Columbia)Manor Woods ElementaryRunning Brook ElementaryStevens Forest ElementaryThe Young SchoolOther If other school, please specify. Teacher Address City Zip Code Parent Name 1 Parent Name 2 Home Phone Work Phone Cell Phone (Optional) Email Does your child have health concerns? ---YesNo If any health concerns, please specify. Would you like to be a parent helper? Receive a 50% discount. Based on first response. ---YesNo Who will pick-up your child? Please include a phone number, if different from above. My child may be included in photos or video for promotional purposes. ---YesNo Please read. Acknowledge by clicking the box. I hereby give permission for my child to participate in the above class. While all reasonable precautions will be taken to assure my child’s safety and to prevent any injuries from occurring, I will not hold the instructor or the PTA and its officers and members liable for any accident, which may occur. My child and I understand that if, after one warning, any student is: a) unable to maintain appropriate behavior in class; or, b) not picked up promptly after class that student will not be allowed to attend the remaining sessions scheduled for that class. I understand that parents will be notified at the time of the warning and before a child is removed from class. Refunds will not be issued for any student so removed. In addition, I grant permission for the instructor and/or PTA officials to obtain emergency medical care (by calling 911) for my child if it appears necessary. We do not offer refunds for tuition paid once a session has begun, but will provide a credit towards future Yoga Imaginarium programs when warranted. To make sure you are a human, please answer the following question: What is 2+2?
