Name *

First Name

Last Name

Yoga styles (check all that apply) *

Fast - flexibility, cardio and strength building

Med - flexibility, cardio and light strength building

Slow - flexibility, light cardio and light strength

Restorative or gentle

Postures - Beginner

Postures - Intermediate

Postures - Advanced

I'm not sure and will discuss with you

Preferences (click all that apply)? *

Hands on adjustments

Meditation

Breathing exercises

Incense

Yoga Props (blocks, straps)

Not Sure

I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension. Participation in yoga class includes, but is not limited to, participation in meditation techniques, yogic breathing techniques, and performing various yoga postures. Yoga postures, or asanas, are designed to exercise every part of the body―stretching and toning the muscles and joints, the spine and the entire skeletal system. They also work on the internal organs, glands and nerves. Yoga incorporates sustained stretching to strengthen muscles and increase flexibility. Yoga is an individual experience. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. My signature acknowledges I understand that in yoga class I will progress at my own pace. If I experience any pain or discomfort, I will listen to my body, adjust the posture and ask for support from the teacher. I will continue to breathe smoothly. If at any point I feel overexertion or fatigue, I will respect my body’s limitations and I will rest before continuing yoga practice. Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. I affirm that I alone am responsible to decide whether to practice yoga. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against TEACHER. By signing my name below, I acknowledge that participation in yoga classes exposes me to a possible risk of personal injury. I am fully aware of this risk and hereby release TEACHER from any and all liability, negligence or other claims arising from or in any way connected with my participation in yoga class. My signature further acknowledges that I shall not now or at any time in the future bring any legal action against TEACHER; and that this waiver is binding on me, my heirs, my spouse, my children, my legal representatives, my successors and my assigns. My signature verifies that I am physically fit to participate in yoga classes and a licensed medical doctor has verified my physical condition for participation in this type of class. If I am pregnant or become pregnant or am post-natal, my signature verifies that I am participating in yoga classes with my doctor’s full approval. I realize that I am participating in yoga classes at my own risk. My signature is binding to this liability waiver from this day forth. *

I agree to the above terms and conditions