Thank you for booking your class! Please take the time to complete this form prior to class- thank you! New student registration Name * First Name Last Name Email * Phone * (###) ### #### Are you happy to be added to the subscription list to receive updates and information on offerings and classes? Yes! Subscribe me! No, thank you. Please contact me only if it's relevant to my booked class Postcode Date of Birth Emergency contact name & phone How did you hear about these classes? Please indicate any injury or health concerns Ankles Arthritis Asthma Back Blood pressure Heart Hearing Hips Knees Neck Shoulders Wrists Vision Pregnancy- indicate month Other - elaborate Other- please elaborate Pregnancy- how many months? Liability Waiver I understand that yoga involves physical movement affecting our skeletal, muscular and physiological body. I am aware that is may not be suitable or safe for someone with injury or illness. I affirm that I alone am responsible to decide whether yoga practice is safe and suitable for my body. I agree I am solely responsible for my safe yoga practice I will notify my teacher of any new or existing injury or health concerns Thank you! Thank you- see you on the mat soon!