Student Registration/Contact Form
PRIVATE & CONFIDENTIAL
Do you have any of the following conditions? (tick any/all that apply)
Please give details of anything that you have ticked in the next section. Tell us anything important, e.g. if you are on any medication.
Asthma or breathing difficulties
Heart or circulatory condition
High or low blood pressure
Back, neck or joint problems
Recent injury or surgery (6 months)
Sensory or cognitive impairment
Serious Mental Health issue
Anything else (please let us know, even if you think it is not relevant)
Please give details of anything that you have ticked above. Tell us anything important, e.g. if you are on any medication.
Are you happy for Graeme to contact you?
Please note this will only be for updates and news relevant to yoga classes e.g. if a class is cancelled. Your data is held confidentially and in accordance with the Data Protection act.
DECLARATION AND LIABILITY WAIVER. PLEASE READ INSTRUCTIONS CAREFULLY
Participation in Yoga classes 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. I understand that in yoga class I will progress at my own pace. If at any point I feel overexertion or fatigue, I will respect my body’s limitations and I will rest before continuing yoga practice. I confirm that I am physically fit to participate in yoga classes and if appropriate a doctor has verified my physical condition for participation in this type of class. I agree to inform the teacher if I have any injuries or aches or pains or if I am pregnant. If I am pregnant or become pregnant or am post-natal, I confirm that I am participating in yoga classes with my doctor or midwife’s full approval.
I have read and agree with the above statement (tick)
Type what you see in the box