General terms of The Balance Collective
REGISTRANT DETAILS:
Name: ___________________________________________________________________
Address: ________________________________________________________________________
City: _________________________ Prov:______________ Postal Code:___________________
Email: __________________________________________________________________________
EMERGENCY CONTACT: __________________________________________________________
EMERGENCY CONTACT PHONE NUMBER: ___________________________________________
Have you practiced yoga before? YES/NO (Please circle)
If YES, for how long? ______________________________________________________________
Limitations/Injuries: _______________________________________________________________
Do you have numbness/pain in (circle all that apply): neck shoulders elbows hands wrists hips lower back upper back knees feet other (please note):___________________________
Waiver 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.
I, the undersigned, understand that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including yoga. I recognize that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I will not perform any postures to the extent of strain or pain.
I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of the class. Those under 18 years of age must have this form signed by a parent or guardian.
___________________________ __________________________ ______________ Name (Print) Signature Date
__________________________ __________________________ ______________ Parent/Guardian Signature Date
Name: ___________________________________________________________________
Address: ________________________________________________________________________
City: _________________________ Prov:______________ Postal Code:___________________
Email: __________________________________________________________________________
EMERGENCY CONTACT: __________________________________________________________
EMERGENCY CONTACT PHONE NUMBER: ___________________________________________
Have you practiced yoga before? YES/NO (Please circle)
If YES, for how long? ______________________________________________________________
Limitations/Injuries: _______________________________________________________________
Do you have numbness/pain in (circle all that apply): neck shoulders elbows hands wrists hips lower back upper back knees feet other (please note):___________________________
Waiver 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.
I, the undersigned, understand that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including yoga. I recognize that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I will not perform any postures to the extent of strain or pain.
I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of the class. Those under 18 years of age must have this form signed by a parent or guardian.
___________________________ __________________________ ______________ Name (Print) Signature Date
__________________________ __________________________ ______________ Parent/Guardian Signature Date