ART Excel forms for Malvern_202010

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					                                      Art of Living ART Excel Course
                                 Registration Form ~ Malvern 20th-24th August 2010

Child’s Name:
Age: ______Gender:          M        F           Date of Birth ____/_____/_______

Parent or Guardian’s name ________________________________________________________

Full Address: __________________________________________________________________

________________________________________________ Post Code: ______________

Tel : _______________________ Mob: _______________________

Email Address: __________________________________________________________________

Please list any Dietary / Health / Psychological Conditions or concerns:______________________


Favourite talents and skills your child could share with others: ________________________


Previous ART Excel courses taken by child?   YES    NO
 (If yes, list date, location, and teacher):

By signing below, I give my son/daughter permission to participate in the ART Excel Course conducted by
an Art of Living teacher. I understand my son/daughter needs to attend all sessions and fully participate to
maximize his/her benefits.
(Parental signature required)

Cost of the courses will depend upon when the balance of the full fee is received:
       £25 discount if full fee is received by 15 July = £275
       Full fee payable if received after 15 July = £300

        I will share a room with my parent/guardian named: _______________________________
Other accommodation option/request: _____________________________________________________

Deposit paid £………………………………..…. Balance outstanding £………………………….

Full Fee paid..£...................................................Discount given: £____________Date:...........2010

Please send the form together with a non-refundable deposit of £100 or
preferably the full payment to: Fatema & Deepak Paretha,

19 Saltcroft Close, Pilgrims Way, Wembley, Middx, HA9 9JJ
Make cheques payable to “The Art of Living Foundation UK South”
                                             ART OF LIVING FOUNDATION UK
                                            ART Excel Course for 8-13 year olds

                                                Medical Liability Release Form

Child’s Name:____________________________________ Date of birth:__________
Post Code____________________
Tel: ( ______)_______________

Please give the name of the person with parental responsibility for your child outside course hours during this
residential event and say which course (if any) they will be attending:

Name of responsible person: _______________________ Relation to the child: _____________
Mob No. _______________________ Course they will be on: ________________________________

                                                  Parent/ Guardian
I,___________________ (parent/guardian´s name), give permission for the above named child to attend the ART
Excel Course on the following date(s): ________________. If needed for health reasons, I give permission for
my child to be evaluated, diagnosed, treated, and/or given medication in accordance to standard medical
practice by licensed medical personnel. I relieve the Art of Living Foundation, its Teachers, Trustees and/or
Directors of all responsibility and consequence that may arise as a result of treatment. I will not hold the Art of
Living Foundation, its Teachers, Trustees and/or Directors liable in the event of injury. Further, I agree to
accept any and all financial responsibility as a result of scheduling medical treatment.

My child agrees to abide by all the rules and regulations stated by the Art of Living Foundation and the ART
Excel staff. I understand that the Art of Living Foundation will not be liable if my child fails to cooperate with
regulations, and that any infraction of the rules may result in immediate dismissal from the activity at my

I hereby give the irrevocable and unrestricted rights to use my son or daughter’s performance (in whole or part), image, name, voice,
writing, and likeness for all non-commercial written, audio and/or visual presentations. I understand and acknowledge that the
written, audio and/or video presentations may be used in brochures, videos, and on website for the purposes of advancing the ART
Excel course around the world. The International Art of Living Foundation UK is a non-profit, educational and humanitarian
registered UK charity ( No.1131480).

         Parent/Guardian´s Signature: __________________________________________

         Child´s Signature: _______________________________________________

Family Doctor: __________________________ Tel: (________)_________________
Allergies: __________________________________________________________________
Current medications: ________________________________________________________
Medical history: _____________________________________________________________
Participant´s N H S number: ___________________________________

In case of emergency, please contact:
Name: _______________________________Relation to child__________ Phone: _______________________
Name: _______________________________Relation to child__________ Phone: _______________________

                                **One form must be completed for each child attending**
                20th-24th August 2010 ~ Malvern St James, Worcestershire, WR14 3BA

Daily Timings:
Daily sessions will start at 9:45am and will end before supper at 6:00pm (except the initial session which
will take place Friday evening).
Although lunch break is 1-3pm and you are welcome to be with your children for the whole lunch period –
we ask that you ensure you are with your children between 1.30-2.30pm as there
will be no care provided at this time.

What to send with your child:
* Comfortable clothes for games, sport and getting muddy outdoors!
* Please provide a change of clothes everyday in case your child gets cold and wet.
* Water bottle so as not to get dehydrated!
* Suntan lotion (please label the container with your child’s name) and sunhat.
* Cushion, blanket and yoga mat so that your child is comfortable during rest/quiet periods
* Trainers/wellies to explore the surrounding area
* Warm clothes and wet weather clothing – we will go outside every day no matter what the English
summer weather!
* Bag to bring all of the above to the course every day

Any Questions?

Contact: Debbie Turner: 07931 731 667 | 0161 790 1322 |

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