PERSONAL INFORMATION

Full Name

Email

Phone

Have you done yoga/pilates before?
Yes, a few timesYes, a lotNo

How did you find about us?
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MEDICAL HISTORY

Please tick off if you suffer from any of the following medical condition:
AsthmaArthritisEpilepsyDiabetesRepetitive strain injuryHigh blood pressure levelLow blood pressure levelNone medical historyOther

Are you pregnant?
YesNoNot applicableNot sure

SYMPTOMS

Please check if you have any of the following symptoms:
CrampsMuscular painWrist painNeck painShoulder painBack painKnee painAnkle painNo medical symptomsOther

TERMS AND CONDITIONS

I understand that the instructions given throughout the classes are intended as guidance only. I understand that while all due care will be taken by the instructor they cannot be responsible for my improper practice at any time.

To ensure that no personal injury occurs, I agree to adjust my practice according to my limitations and the decision to perform any yoga postures remains mine.

I declare that I will take full responsibility for myself during the classes. I will notify my instructor before each class begins of any recent injury, illness, surgery or pregnancy.

Once you have commenced your course there are no refunds. It is a 7 week consecutive course inclusive of the 7 weeks starting from the commencement date. You are committing to the full length of the course.

By agreeing with this terms, I further state that I have carefully read the foregoing release and know the contents of thereof, I fully understand it and agree with it, and I accept this terms on my own free act.

I agree and accept Terms and conditions

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