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.
Emergency Contact (if different)
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:*
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.
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
Does your child have any diagnosed medical conditions?*
Does your child have any allergies?*
Does your child require medication that may be needed during sessions?*
Does your child have any additional needs, learning differences, sensory needs, behavioural needs, or support requirements that would help us support them effectively?*
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*
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:
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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