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
​
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.
​