Student Details & Waiver Form

Thank you for practicing with Kind Yoga. Please complete the following to assist us in ensuring that you get the most out of your classes. Confidentiality of information is guaranteed.

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Thank you for your response. ✨

First Name

Surname

Pronouns (if you'd like to specify)

Address

Phone

Please tick if you would like to receive email updates / newsletters from Kind Yoga

Emergency Contact Name

Emergency Contact Phone

Have you practiced yoga before?

Yes

If YES, for how long / which styles?

Other than yoga, what types of exercise are you currently doing, if any?

Limitations / Injuries / Surgeries / Pregnancy / Other relevant details

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. (Please tick the box to acknowledge that you have read and agree with this statement).

I (as named above) understand that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. By submitting this form, I affirm that a licensed physician has verified my good health and physical condition to participate in yoga classes. In addition, I will notify the teacher of any medical conditions, injuries or physical limitations before each class. I will not perform any postures to the extent of strain or pain. If I am pregnant, become pregnant or I am post-natal or post-surgical, by submitting this form I verify that I have my physician's approval to participate. (Please tick the box to acknowledge that you have read and agree with this statement).

I accept that neither the teacher, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of the class. (Please tick the box to acknowledge that you have read and agree with this statement).

How did you hear about these Kind Yoga classes?

Thank you for your response. ✨

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