The Yoga Place - Registration Form & Disclaimer

Name

Mobile Number

Date of Birth

Please advise any medical conditions and/or injuries

Emergency Contact Details

Emergency Contact Name

Emergency Contact Phone Number

Yes I agree to receive quarterly email updates with class and workshop info.

Disclaimer Terms

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By clicking Send & Agree, I am aware that:

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* During a yoga class I am required to self-regulate which means resting if I need to, or adapting movements to suit my own body and condition.

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* I should let the instructor know if I am experiencing pain or discomfort during the class so that the movement or position can be adapted, modified or left out.

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* I can opt out of any exercise or position at any time, for any reason.. In particular if it is causing pain or discomfort. 

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I declare that I have disclosed my medical conditions and injuries in this form and will update my instructor with any new conditions or injuries if they arise.

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We send out quarterly newsletters with events, workshops & notices for class renewals for the upcoming term. You may unsubscribe at any time.

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If you'd prefer, you may Download a Copy of this form & fill it in manually to bring to class.

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