The information provided on this form will be treated as strictly confidential. Please ensure that the information is complete and accurate.
EMERGENCY CONTACT
MEDICAL PROFILE
If you have answered YES, to any of these questions please list any details:
ACKNOWLEDGMENT
By attending this class, I affirm that I am solely responsible for my health and well-being, as well as my decision to practice yoga, a program of physical exercise. I agree to inform my yoga instructor of any activities or movements which I feel could cause injury to myself. I understand that yoga/meditation/breathing techniques/wellness therapy are not recommended and are not safe under certain medical conditions. I do not have any physical conditions or disability that would limit my participation or preclude an exercise program.
shall not be held liable for any injury, loss, or damage to property and/or persons sustained during or as a result of participation in these classes. I agree to listen to my body and monitor myself during every class session.
