Form October | NeuroYoga+

Please complete the registration form below.

After submitting the form, click the payment button to confirm your child’s place for the October NeuroYoga+ course (4 sessions).

Your place will only be secured once payment is received.

Child’s Name *

Childʼs age *

Any medical & support needs *

Yes
No

If yes, please describe the medical or support needs

Full name of parent/carer providing consent *

Phone Number *

Email Address *

Media Consent Options (select all that apply) *

Yes, for internal and promotional use
No, I do not give consent

Consent Confirmation *

I confirm that I have read and agree to the policies listed above.
I consent to the processing of my child’s and my personal data in accordance with the Privacy Policy.

Date of submission *

After submitting the form, please click the button below to complete payment.

Payment