Connected Kids Program

(Term 2, 2022)

Please complete this form prior to Sunday 22 May

Parent name

First Name

Last Name

Phone number

Childs name

First Name

Last Name

Childs name (#2)

First Name

Last Name

Please share any relevant emotional or physical information on your child that the teacher may need to be aware of (injuries, anxiety etc)

Consent

The program will use essential oil sprays as a meditation technique. Your child will also be provided with an essential oil spritz bottle to take home. Oils will be diluted and not used directly on the skin. There may be times when the teacher feels it would help the student/child to be given a hands on adjustment in a yoga pose or in meditation. Kirsty will always ask for verbal consent from the child before giving an adjustment. Please indicate your consent:

I consent to the use of essential oils with my child

I consent to the teacher giving an adjustment to support the alignment of a yoga posture or to deepen meditation

I consent to photos of my child which may be shared on social media

Subscription

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