Free Class Registration

Thank you for helping to save the environment by completing this form online.
 
yyyy-mm-dd (click on the month and year at the top of the date picker)
Contact Details

Medical Information

Indemnity

I, the parent of the above listed child,

  • understand that whilst my child attends Mindful Minis, the person in charge will act in Loco Parentis.
  • do not hold Mindful Minis or any member of its staff or any participant of the Mindful Minis training program responsible for any sickness or injury occurring while my child attends Mindful Minis.
  • hereby indemnify Mindful Minis and all its members of staff and all its training participants against any claim for injury or loss sustained by my child and I undertake to pay any medical expenses incurred as a result of such injury.
  • agree to give Mindful Minis permission to use photographs or video recordings of myself or my child for any Mindful Minis promotional materials, including the Mindful Minis website and Facebook page. I understand that my child will not be identified by name, nor will any compensation be extended for such use.
By signing and submitting this indemnity form, I am signing that I understand and accept the above terms and conditions.
Please print your name and surname