Baby & Parent Yoga Registration Form
Tuesdays at 11:00am - 12:00 pm | Baby & Parent Yoga
Registration & Payment
Classes are offered in 6-class terms for $150 ($25 per class). To receive the term rate, registration and payment must be completed on or before the first class of the term. For a list of Term Start Dates,
click here
.
After the term begins, registration is available by drop-in only at $30 per class.
Payment can be made:
- Online through this form (at the bottom)
- In person by cash, cheque, debit or credit before the start of class
- By e-transfer to
churchoffice@rosedaleunited.org
in advance of your class. Be sure to include the class you are registering for in the notes section.
If you have any questions about your registration, please email
churchoffice@rosedaleunited.org
.
Name
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Email
*
This address will receive a confirmation email
Phone
*
Baby's Name & Age
Name
*
Birth date
*
Registration Options
Select the Payment Option you prefer
*
Please select one option.
Full Term $150
Single Class $30
If Single Class Payment, for which date?
How do you intend to pay
*
Please select one option.
Credit/Debit using this online form
Cash/Credit/Debit paid in the office
Etransfer to churchoffice@rosedaleunited.org (put Baby Yoga in the notes section)
Online
Emergency Contact
Relationship
*
Please select one option.
Spouse
Adult Child
Adult Grandchild
Sibling
Family Friend
Caregiver
Emergency Contact Name
*
Emergency Contact Cell Phone Number
*
Do you have any allergies or medical conditions we should know about?
*
Please select one option.
Yes
No
If yes, please list
PHOTO CONSENT: To promote our program, we may capture photos/videos during class activities. These images may be used for promotional materials (flyers, posters, brochures), organization website, social media platforms, newsletters and reports.
*
Please select one option.
Yes, I give permission to be photographed, video recorded, and have my image used for the purposes stated above. I understand these images may be shared publicly. I understand that no personal information (e.g., full name) will be shared without addition
No I do not give permission
Online Payment
Single Class (30 CAD)
I will pay in person or via e-transfer (0 CAD)
Single Class (30 CAD)
I will pay in person or via e-transfer (0 CAD)
Amount
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
Tuesdays at 11:00am - 12:00 pm
Baby & Parent Yoga
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