Thank you for registering for Sip and Stretch at ChesLen Preserve. Please note that each participant will need to complete an individual registration.

Water bottles and yoga mats will be provided. We ask that if you attend multiple events, you bring the provided yoga mat with you to subsequent events.

Name

First Name

Last Name

Phone

(###)

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####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I would like to register for

Weds, June 23rd @6:30pm

Weds, July 14th @6:30pm

Weds, August 11th @6:30pm

Weds, September 8th @6:30pm

Do you require any special accommodations? If so, please describe here.

In consideration of my participation in this Sip and Stretch event, I assume all risks associated with the event. Having read this waiver and knowing these facts and in consideration of your accepting my registration, I, for myself and anyone entitled to act on my behalf, waive and release Quest Therapeutic Services, Inc., Natural Lands, Christine Meyer, MD and Associates, Jennifer Morgan Wellness, all event sponsors, their representatives and successors from all claims or liabilities of any kind arising out of my participation in this event, even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. I also authorize uest Therapeutic Services, Inc., Natural Lands, Christine Meyer, MD and Associates and Jennifer Morgan Wellness to utilize any photographs and/or video recordings of my participation in any event for any and all purposes, and to communicate with me about future events/promotions.

If you agree to the above statement, please type your name in the box below.

Quest Therapeutic Services

Quest Therapeutic Services provides exceptional pediatric therapy services to enhance the lives of children with disabilities in the Delaware Valley.

Sip and Stretch Registration

Quest Therapeutic Services