HEALTH & WAIVER FORM

GROUP CLASSES

PRIVATE YOGA

WORKSHOPS

Please enter your details into the form below

If at any time during your practise you feel pain, strain or discomfort gently ease out of the posture. It is important while practising yoga, to listen to your body and respect its limit on any given day. At any time during class, you can take rest

All information on this form will be kept strictly confidential & stored in accordance with data protection laws.

Full Name

Birthdate

Phone Number

Are you/could you be pregnant?

Yes

EMERGENCY CONTACT Name/Phone Number

Please detail anything regarding your health we should know about

I may be contacted by phone and email.

I understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment. I should consult with a physician prior to beginning any activity program, including yoga. I will not perform any postures to the extent of strain or pain and I recognise that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from taking the class.

Initials

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