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As your teacher, it is important that I have a full understanding of your current health.  For this reason, the questions on this form should be answered thoroughly.  You should not knowingly omit any information that may affect your health or safety during your yoga practice.  Any information provided on this form will be treated as confidential and will not be shared with third parties.

Please complete before your first class.


Have you practiced yoga before?


*if none please type "NONE"



Please read this carefully.

The practice of yoga involves physical activity (asana), breathing exercises (pranayama) and meditation.  As with all physical activity, the risk of injury, even serious or disabling is always present and can not be entirely eliminated.  During class the teacher will provide verbal cues inviting you to move and breathe in a particular way, these cues are guidelines only.   You should always work to your own ability.  It is your responsibility to notify the teacher of any injury or ailment (recent or ongoing) prior to every class.  Yoga may at times be challenging, but should never be painful.  If at any time you believe something is unsafe for you, or that you are unable to practice due to physical injury or medical condition, you should stop what you are doing and notify your teacher immediately.  Should you feel unwell including, but not limited to, displaying symptoms of the Coronavirus you must not attend your scheduled class or course.  By signing your name below, you confirm that you acknowledge and agree to the terms contained in the above waiver of liability statement.  You are aware of (and assume) the risks and hazards of participating in yoga classes, and agree to assume full responsibility for any injury/or damages, which you may incur as a result of your voluntary participation.

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