Yoga Class Waiver Form

***Please note all of the information on this form is kept confidential.

Full Name:

Address:

Telephone:

DOB(DD/MM/YYYY):

Email:

example@example.com

Gender

Are you pregnant?

How did you hear about us?

Did you practiced yoga before?

Which class(es) you will be attending?

Please check any existing or past conditions:

Emergency Contact Name & Number:

Join the monthly newsletter:

If at any time during this class you feel discomfort or strain, gently come out of the posture. You may rest at any time during class. It is important that you listen to your body and respect its limits on any given day.

I understand that yoga is not a substitute for medical attention/treatment and I should consult a physician prior to beginning any activity program, including yoga. I recognize that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I will not perform any postures to the extent of strain or pain.

I accept that neither the instructor, nor the hosting facility is liable for any injury, or damages, to person or property.