New Student Registration
Emergency Contact Name
Emergency Contact Number
Medical Conditions (Also list any medications you are taking)
Previous yoga experience
Some, but a long time ago
less than a year - beginner level
regular practice for more than a year - intermediate to advanced level
If you have practised yoga before, what style/s have you practised?
vinyasa / power
yin / restorative
no idea what style I've practised!
Anything else you want me to know?
How did you find out about Tracy Gray Yoga?
Friends / Family
I, the participant, acknowledge the following:
- I am engaging in physical activity which may involve some risk of injury
- I have received advice from my physician with respect to any past or
present injury, illness, health concern or medication that may affect my
participation in this physical activity and have clearance to participate.
- I have listed all injuries, medical conditions and medications on this
- I understand Tracy Gray and staff have a duty of care to uphold and
that outside of that duty of care, any injuries or loss are my
responsibility. I hereby release Tracy Gray from liability arising from
injury or loss outside of her duty of care.
I have read, understood and agree to the liability release
Your details are kept confidential. Medical information is only collected for the
purpose of sharing with emergency personnel in the case of an emergency.
Your contact details are not shared with anyone outside of Tracy Gray Yoga
and only used for the purpose of correspondence with you.
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