Welcome to Village Yoga
This is our Liability Waiver and Emergency Contact form. It is MANDATORY that each and every student fills it out and acknowledges their signature at the bottom. Thank You, Merrily & MJ McDonald
**** This information is for the SOLE USE of Village Yoga, LLC ***
Your First Name
Your answer
Your Last Name
Your answer
WAIVER
I acknowledge and agree to the Waiver above by checking "Acknowledgment" Below.
Required
Your Cell Phone #
Your answer
Zip Code
Your answer
Birth Date
MM
/
DD
/
YYYY
How did you hear about us?
Have you seen Village Yoga on...
In case of a Minor (under 18 years of age), Your First & Last Name
Your answer
I acknowledge and agree to the Waiver above by checking "Acknowledgment" Below in the case of a Minor.
Emergency Contact
Your answer
Emergency Contact Relationship
Your answer
Emergency Contact Phone #
Your answer
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