DISCOVER BALANCE
in
Stand Up Paddleboard Yoga
January 2016
Explore balance, strengthen your core and your sense of serenity in this fun floating
adventure. During this 60-minute on-water class with boards anchored in place, you will
flow through a series of seated, standing and reclining poses along with relaxing breath
work and a tranquil Savasana. Discover a new floating perspective! Must have yoga
experience and be able to swim. This class is suitable for those new to paddling.
Class size is limited to 7
 Pre-registration at the Crozet YMCA Front desk by Tuesday for the following Wednesday class
and by Friday for the following Sunday is required
 Wear full coverage bathing suit or comfortable workout clothes you don’t mind getting wet.
 Please arrive 15 minutes prior to the class to check in and change (showers and locker room are
available)
WHEN:
Sundays: January 3, 10, 24 and 31 12:30-1:30pm

Wednesdays: January 6 – February 3 10:30-11:30am
PRICING:
$20 member/$27 non-member
Sign up for 3 classes or more and
get a $3/class discount
LOCATION: CROZET YMCA
434.205.4380
WWW.PIEDMONTYMCA.ORG
INSTRUCTOR: Catherine McMahon
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CROZET YMCA
PROGRAM REGISTRATION FORM
□ Crozet PARC YMCA Member □ Non-member
Participant’s Name___________________________________________DOB________________Age__________Gender________ Parent/Guardian’s Name______________________________________
Non-members only: Street Address_________________________________________________City______________________________Zip________________Phone__________________________________
Primary Email_________________________________________________Parent/Guardian’s Name_______________________________________________Alt. Phone__________________________________
TEAM NAME: ______________________________________________________________
REGISTRATION PROCEDURES:
· Mail your completed registration form, including payment, to 1075 Claudius Crozet Park, Crozet, VA 22932
· Drop off your completed registration form, including payment at the Crozet PARC YMCA.
· Fax your completed registration form, including payment information, to 434-205-4385.
· Register online at piedmontymca.org/registration. Please note that online registration is not available for all programs.
PROGRAM DAY/TIME SESSION FEE
Payment (CIRCLE ONE) CASH CHECK CREDIT CARD Visa MasterCard Discover
□ E-wallet on file. Only signature required below.
Card #_______________________________________________________________________Exp. Date__________/_________CID__________________
Card Holder’s Name____________________________________________Card Holder’s Signature_________________________________________Date________/_______/_______
Agreement *Must Sign*
I hereby certify that my child is in good health and capable of safe participation in this YMCA program. I understand that the PARC/YMCA assumes no re-sponsibility for any
possible injuries or illness sustained as a result of my child’s participation in any athletic program, sport or activity and that I assume all risks thereof. I assume all risk(s) and
hazards incidental to this program and for the transportation to and from the program. I hereby authorize the YMCA to obtain medical treatment for my child in the event that
the above parent contact(s) cannot be reached. I hereby release and discharge the PARC/YMCA, its agents, servants and employees from any and all claims for injury, illness,
death, loss or damage which my child may suffer as a result of his/her participation in these activities. I understand that the PARC/YMCA is not responsible for personal property
lost or stolen while members and/or program participants are using the PARC/YMCA facilities and/or are on YMCA/PARC premises. I give the YMCA/PARC permission to print,
publish and display pictures of my child, with-out limitation, in order to promote YMCA/PARC programs. I understand that the YMCA may, in its sole discretion, cancel scheduled
practices, classes and/or games as it deems appropriate based on, but not limited to, inclement weather conditions, facility availability and/or conditions. No refunds or prorated refunds will be issued except at the sole discretion of the YMCA. Refunds will only be issued for programs that are cancelled due to an insufficient number of participants.
By signing below, I agree to all of the terms and conditions as set forth in this Waiver.
__________/__________/________
Parent/Guardian Signature Date
Office Use
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