EmailMe Form - PREGNANCY YOGA Class Registration Form

Name *

First Last

Mobile Phone *

Email *

Emergency Contact (Next of kin) *

First Last

Emergency Contact Mobile Number *

Which pregnancy yoga course are you registering for? *

Please select the location and start date of the course

Expected Due Date *

DD / MM / YYYY

Have you suffered from any of the following during your pregnancy?

Please tell us about any other pregnancy ailments you have suffered

Please tell us about any injuries you have which may affect your yoga practice

What are you hoping to get out of your pregnancy yoga classes?

Client Disclaimer *

I agree

I do not agree

I, the above named participant, understand that all practices are optional; I hereby waive any and all claims I have now or in the future against Yummy Yoga and my teacher. I take full responsibility for my body and my baby. If I feel dizziness or pain I shall stop the activity immediately and let my teacher know. If I have any doubts I will seek the advise of a medical professional before proceeding with the pregnancy yoga class.