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Wild Within Kids Consent form and Medical Par Q

Welcome to Wild Within yoga. Please take a few minutes to complete this form.


Your answers help ensure that sessions are safe, supportive, and adapted to your child's needs.


All information is kept confidential and used only to support your well-being during practice.

Child's Details

Date of Birth
Day
Month
Year

Parent/Guardian Details

Emergency Contact (if different)

Collection Arrangements

Please notify us in advance if someone different will be collecting your child.

Photography & Social Media Consent

From time to time, photographs may be taken during Within Kids sessions for promotional purposes. Please tick one:

Behaviour Expectations

Within Kids aims to provide a safe, supportive, and inclusive environment for all children.


I understand that:

  • Children are expected to behave respectfully towards others.

  • Disruptive, unsafe, or aggressive behaviour may result in a discussion with parents/guardians.

  • Persistent unsafe behaviour may lead to a child being unable to continue attending sessions.

Parent/Guardian Consent

I confirm that:

  • The information provided is accurate.

  • I have completed the accompanying Health & Medical Form.

  • My child is participating voluntarily.

  • I understand yoga, movement, mindfulness activities, games, and relaxation exercises will form part of the sessions.

  • I understand that While Within Kids takes reasonable steps to provide a safe environment, participation is undertaken at my child’s own risk.

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Within Kids Child Health & Medical PAR-Q

Date of Birth
Day
Month
Year

Medical Information

Does your child have any diagnosed medical conditions?

Allergies

Does your child have any allergies?

Medication

Does your child require medication that may be needed during sessions?

Additional Support Needs

Does your child have any additional needs, learning differences, sensory needs, behavioural needs, or support requirements that would help us support them effectively?

Emotional Wellbeing

Is there anything you would like us to know that may help support your child’s confidence, participation, or emotional wellbeing?

Physical Activity Readiness

To your knowledge, does your child currently have:

Heart or Medical Conditions
Asthma requiring regular medication
Epilepsy or seizures
Recent surgery or injury
Joint, muscle, or mobility concerns
Any condition that may affect participation in gentle exercise or yoga

Illness & Infection Policy

To help protect all children attending:

  • Children should not attend sessions if they are unwell.

  • Children should be symptom-free for 48 hours following sickness or diarrhoea before returning.

Parent Declaration

I confirm that:

  • The information provided is accurate and complete.

  • I will inform Within Kids of any changes to my child’s health or emergency contact details.

  • I understand that yoga, movement, mindfulness, games, and relaxation activities will be adapted to suit children but involve physical participation.

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Date
Day
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