HD Yoga Membership Form

*Please note that all information on this form is kept confidential

Full Name

Address

Town

Email

Emergency Contact

Post Code

Phone Number

Emergency Contact Phone Number

Have you practiced yoga before

Yes

No

If yes, for how long

Do you have any limitatons or injuries

Any other medica conditions?

Waiver

If at any time during the class, you feel discomfort or strain, gently come out of the posture. You may rest at any time during the class. It is important in Yoga that you listen to your body and respect its limits on any given day

I confirm that I understand that Yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including Yoga. I recognise that it is my responsibility to notify my teacher of any serious illness or injury before every Yoga class. I will not perform any postures to the extent of strain or pain.

I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of the class. Those under 18 years of age must have this form signed by a parent or guardian.

I have read, understand and fully agree to the terms of this Agreement. I understand and confirm that by signing the Agreement I have given up considerable future legal rights. I have signed this Agreement freely, voluntarily, under no duress or threat of duress, without inducement, promise or guarantee being communicated to me. My signature is proof of my intention to execute a complete and unconditional WAIVER AND RELEASE of all liability to the full extent of the law. I am 18 year of age or older and mentally competent to enter into this waiver.

I agree to the waiver above and am aware that by checking this box and by clicking submit I am submitting my signature on this form.