Thank you for choosing to practice yoga with me! Please take a few minutes to complete this enrollment form so that I can understand your needs and any medical restrictions you may have. 

Please note: for any classes at studios/gyms sign up is done onsite through their systems.

Name *
Name
Address *
Address
Date of Birth *
Date of Birth
Have you experienced major injuries or significant pain in any of the following areas?
Medical Considerations
Goals for practicing Yoga
Emergency Contact Name *
Emergency Contact Name
I hereby recognise that the instructor is not able to provide me with medical advice in regard to my fitness and this information is used as a guideline only. I have answered the questions to the best of my ability and understand it is my responsibility to exercise according to my own capacity.