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Schedule May 15, 2026: 4:00pm – 9:00pm May 16, 2026: 10:00am – 6:00pm May 17, 2026: 9:00am – 4:00pm Fairfield, Connecticut Participant Information Legal Name *Preferred NicknameName on Certificate (given at graduation) *Facebook NameEmail Address *Mailing Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryDate of Birth *Mobile Phone NumberHome Phone NumberOccupationEmployer Emergency/Contact Information (please provide two if you can) (1) Name *FirstLast(1) Phone * address No previous (1) Email *Relationship to participant(2) NameFirstLast(2) Phone(2) Email(2) Relationship to participant Name of Physician *Physician Phone *Physician Location * Additional Participant Information Please list known allergies (if none, type n/a) *Physical condition (choose one): ExcellentGoodFairPoorAre there any health issues, surgeries, or concerns to share so that I can best support you? Is there any additional information you would like to share with me about yourself?Are you familiar with yoga? NO previous experience is required, we’re just curious. *YesNoDo you have a yoga practice? NO previous practice is required *YesNoAny previous kids yoga experience? NO previous kids experience is required *YesNoHow did you learn about this training? *What do you hope to receive from participating in this training? * DPK Directory of Certified Teachers Would you like to be added to this directory of certified DPK teachers? You can view this directory by clicking here. select Yes or No *YesNoHow your name should appear in directory: *Phone Number if you'd like it in the directory:Email address you'd like in the directory: *Town/state you'd like in the directory: *Would you like to sign up for our newsletter to stay updated on similar events? * *Yes, I want to know about Missy's offerings for adultsYes, I want to know about Missy's offerings for kidsYes, I want to know about Missy's offerings for adults & kidsNo thanks, I'm good. Out of Town Participants Please indicate below if you are traveling from out of town and would like additional information, including hotel options, about the area: *Yes, please send me more information about the local areaNo thanks, I don't need this information. Policies, Waivers, and Agreements Please read the Assumption of Risk and Release of Liability Teacher Waiver Agreement. You can find it via the link below. *I have read and agree to the Assumption for Risk and Release of Liability Teacher Waiver Agreement.View the Assumption of Risk and Release of Liability Teacher Waiver Agreement here. Please read the Photo and Video Release form, and indicate your preference below. You can find the Photo and Video Release form via the link below. *I have read and agree to the Photo and Video ReleaseI have read and DO NOT agree to the Photo and Video ReleaseView the Photo and Video Release form here. Payments are nonrefundable unless the program is canceled by Deep Play for Kids, LLC (“DPK LLC”). DPK LLC will not be responsible for reimbursing any travel or lodging expenses, including but not limited to airline tickets, train fares, or hotel reservations. If a registrant cancels 15 days or more before the program start date and provides written notice to DPK LLC, a $200 administrative fee will be deducted, and the remaining balance may be refunded. No refunds will be issued for cancellations made fewer than 15 days before the program start date. By selecting "I Agree" below, I, the registrant, acknowledge that I have read, understand, and agree to these terms and conditions. *I Agree Program Cost & Payment Information DPK is proud to offer tiered tuition pricing as follows: please indicate the price you are paying. *Actual Cost of training - $750.00Support Someone in need with additional funds - $850.00Reduced Cost for those in need - $650.00Total$0.00Coupon Code Apply Credit or Debit Card Information *Submit