EmailMe Form - Mum and Baby YOGA Class Registration Form

Name *

First Last

Baby's Name

Baby's DOB

MM / DD / YYYY

Email *

Mobile Phone *

Emergency Contact (Next of kin) *

First Last

Emergency Contact Mobile Number *

How was your birth experience

*

Have you had your 6 week postnatal check?

Please tell us about any other ailments or difficulties you have had or any injuries 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.

Date Time

MM / DD / YYYY

Checkbox

First option

Second option

Third option