top of page

The Yoga Place - Registration Form & Disclaimer


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

By clicking Send & Agree, I am aware that:

* 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.

* 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.

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

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.

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

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

bottom of page