By signing below, I confirm that:

I am over 18, not pregnant, and it has been at least 6 weeks since giving birth (if applicable).
I am in good physical health and understand that yoga involves physical activity which carries a small risk of injury.
I take full responsibility for my own wellbeing and will modify or stop if I feel discomfort or pain.
I will inform the instructor of any injuries, medical conditions, or recent surgeries that might affect my practice.
I will not attend if unwell or at risk of spreading infection (including COVID-19).
I understand that participation is voluntary and at my own risk, and release the instructor and venue partners from liability for injury or illness arising from participation.
I consent to receive verbal guidance and visual demonstration during class.
I will inform the instructor if I do not wish to have any hands on adjustment.

Name

By completing this form I agree to the above

First Name

Last Name

Additional information

Please include past yoga practice and any physical or medical conditions you think your instructor should know about.

Emergency Contact information

First Name

Last Name

Relationship to you

Phone

(###)

###

####

Dr Mitzi Noble-Munuo