2019 Yoga Enrolment Form

Stress-Less Health

Monday & Thursday Baldivis Participant Registration Form
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail
Phone Number
Next of Kin

First NameLast Name
Next of Kin phone number

Area CodePhone Number
Injuries/medical history (state nil if none):
Any other information:
Liability Waiver (please check box)

I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, adjust the posture and ask for support from the teacher. I will continue to breathe smoothly.
I agree to allow any photographs taken during classes which contain my image to be used by Karen Holden-Rankine and Stress-Less Health in any future advertising/promotions.
My Products
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Monday & Thursday Term Pass ($16 per class)$192.00 AUD

Monday PM Yoga Term Pass ($18 per class)$108.00 AUD

Monday PM Yoga 5-Class Pass ($20 per class)$100.00 AUD

Thursday PM Yoga Term Pass ($18 per class)$108.00 AUD

Thursday PM Yoga 5-Class Pass ($20 per class)$100.00 AUD

Total $0.00 AUD
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Stress-Less Health