Kids Camp Registration Form

Yoga, Mindfulness, Music, Art, Brain Boost Activities & Games — A Cultural Immersion Experience

Camp Weeks ** Extended care (3-5 PM) can be arranged on request basis. $27/ hour. Request has to be made at least 15 days prior to the Camp week via email [email protected]

Kid's Information

Kid's Name *

Age *

Gender *

Male

Female

Other

Does your kid have any nut or food allergies? *

Please provide information about your child's current health status and any ongoing medications. *

Parent or Gaurdian Info

Parent's Full Name *

Phone *

Email *

Emergency Contact Phone Number *

Authorized Pick-Up Members *

Mother
Father
Gurardian
Friend
Other

List all individuals authorized to pick up your child from the center. Kindly request that anyone picking up your child presents photo identification upon arrival.

Customers/Students Photos and Videos During Camp *

Yes

I acknowledge and grant Universal Peace Foundation California and their representatives permission to use my child/children's image, voice, and recordings in various formats, including video and still images. I understand that this content may be copied, exhibited, published, or distributed without any expectation of compensation. I acknowledge that these recordings may be displayed online or in public, and this permission has no time limit. This release specifically applies to the recordings of the session listed on this document. I have read and understood this release and agree to its terms. I release Universal Peace Foundation California and its representatives from any claims related to the legitimate use of these materials.

Liability Waiver - Parent or Guardian sign on-behalf of the student *

I Agree

I understand, acknowledge and appreciate that, as with any physical activity, there is some risk of physical injury and damage associated with my participation in meditation and I assume such risk. I represent that I am in good health and suffer from no existing physical impairment/injury or i have disclosed any accordingly. In consideration of the privilege of participating in the yoga program sponsored by Universal Peace Foundation California, I hereby release, discharge and relinquish Universal Peace Foundation California, and its respective officers, directors, volunteers and employees, of and from all claims, demands, actions, and causes of action of any sort, for any injuries sustained in connection with my participation in the yoga program offered by Universal Peace Foundation California. I also express sincere desires for my to learn simple focus & meditation techniques as part of the curriculum. I understand that this technique is being taught to me/ my kid for the purpose of attaining inner peace, bliss, satisfaction and contentment (Santhosham). I promise that I will not disclose the meditation/focus techniques or other yoga instructions/asanas/postures taught (to me) to anyone without the written consent of UPF Cal. I have read the above release and waiver of liability and fully understand its contents.

Communication Terms and Condition *

I Agree

I fully understand and agree to receive Email/Phone calls/SMS messages from Universal Peace Foundation California for communicating like class timings changes due to weather or other reasons, new/upcoming events, and important announcements. Unless otherwise required by law, I understand that UPF Cal never shares any contact info to anyone outside of the organization for any marketing purposes.

Parent/ Gaurdian Full Name *

Parent/ Guardian Signature *

Clear