EmailMe Form - Enrolment Form

Name *

First Last

Date of Birth

DD / MM / YYYY

Address *

Street Address City State / Province / Region Postal / Zip Code Country / Region

Phone

Email

Do you have yoga experience? *

Yes

No

Are you pregnant?

No

Yes

Injury & Illness

To allow us to provide you with a safe and effective practise or class please tick if any of the following apply to you.

Injury/Illness

Please list any relevant details of your injury or illness (anything that might affect your yoga practise):

Postural Alignment & Use of Oils

Happy Being teachers may perform hands on adjustments to improve your alignment in a pose and may spray or anoint you with essential oils to complement your practice or meditation. Please indicate whether or not you consent to this practice.

Hands on postural adjustments *

Yes, I consent

No, I do not consent

Use of oils *

Yes, I consent

No, I do not consent

Please list any oils which you are allergic to

Disclaimer

The teachers at Happy Being will instruct you in practices that are both safe and effective for you with the details that you provide in the notes above. Every effort will be made to ensure your safety in all class practices including warming up, cooling down, static and dynamic yoga postures, breathing practices and meditation. However your instructor can not be responsible for inappropriate yoga practice in or out of class. If you have any concerns about the safety of yoga for your health please consult your doctor prior to commencing.

I understand the above declaration and I take full responsibility for my actions within the class. I understand that the instructions given in class are a guide and that I am responsible for recognising my own limitations to prevent from injuring myself. I agree that the details above are true and accurate.

I Agree *

I have read and understood the above disclaimer.