New student sign-up and waiver

New Student Sign-up & Waiver Form

New to Balance Yoga? Welcome. Just a little formality before stepping onto the mat. Please complete this form online BEFORE attending your first class.
This gathers your personal information and is a liability waiver.
Your personal information is not shared with or sold to any other person or organisation. You may access, review and change your personal information at any time.
If you have any queries about the form please contact me directly.

Name

Contact phone

Date of birth

Physical mailing address

Emergency contact - name

Emergency contact - phone

Yoga experience level

Main reason for attending yoga

Please detail any injuries, or physical/mental/medical conditions that the instructor should be aware of, and/or that may impact your ability to safely participate in yoga, including (but not limited to) hip replacement, heart disease, osteoporosis, cancer, high blood pressure, glaucoma, back injury, other injury, illness or underlying health conditions etc

RISK ACKNOWLEDGEMENT: I understand that yoga includes physical movements and breathing exercises, as well as an opportunity for relaxation, stress re-education and relief of tension. I acknowledge it is important in yoga that I listen to my body, and respect its limits on any given day. I understand I may rest at any time during the class. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or strain, I will listen to my body, discontinue the activity, and ask for support from the instructor. I assume full responsibility for any and all damages, which may incur through participation. I understand that Yoga is not a substitute for medical attention, examination, diagnosis or treatment, and that yoga is not recommended and is not safe under certain medical conditions. I will make the instructor aware of any medical conditions or physical limitations before class. I affirm that, if required, a licensed physician has verified my good health and physical condition to participate in such a fitness program. Further, if I am pregnant, become pregnant or I am post-natal, or pre- or post-surgical, my electronic signing of this agreement verifies that I have my physician’s approval to participate. I also affirm that I alone am responsible to decide whether to practice yoga and participation is at my own risk.

LIABILITY WAIVER:I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Sarah MacDonald and Balance Yoga and all related facilities and premises for any personal injury or negligence. Additionally, the facility, instructor and Balance Yoga are not in any way responsible for any loss or damage of my personal property. I have carefully read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am signing this agreement voluntarily and recognise that typing my name below serves as complete and unconditional release of all liability to the greatest extent allowed by law and that it cannot be changed orally.

Check this box to confirm you have read and accepted the terms and conditions (click link below to read them). The T&Cs include the policy for missed classes (note - refunds are not given for missed classes).

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Signed by:

Date:

Address

Thank-you for completing the form. I look forward to seeing you soon at yoga.

Terms & conditions

Yoga and Breath Coaching - what I offer:

Public yoga classes
Private yoga sessions
Breath coaching for health & wellbeing

Get in touch:

Phone 027 287 3444

Email via the contact form

'The Paper Work'

New Student Sign-up & Waiver Form

Yoga and Breath Coaching - what I offer:

Get in touch: