Iyengar Yoga Detroit Collective New Student Form
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First Name and Last Name *
Gender Pronouns *
Date of birth *
Address, City, State, Zip *
Phone *
E-mail *
Occupation *
Racial identity *
Check any areas of concern:
Please provide pertinent information on items checked above.
Previous Yoga instruction (what type, where, when, teacher’s name):
Why have you decided to enroll at IYDC now?
How did you hear about IYDC? Check all that apply:
I understand that IYDC strives to uphold a trauma-responsive, safer space, which is explicitly anti-racist, anti-classist, body-positive, gender-inclusive, and decolonial. I agree to uphold IYDC mission and policies in my conduct at all classes and events. If I have questions, I will contact IYDC for information and clarity. By typing my name below, I acknowledge my agreement. *
Release of Liability: I acknowledge that it is my responsibility to exercise ordinary care for the protection of myself and others while in class at IYDC. I take complete responsibility for my physical condition and my presence here. I understand that yoga instruction is not a substitute for medical counseling or treatment. I give permission to IYDC to take photographs, that may include me, for the purpose of publicity. By typing my name below, I acknowledge my agreement. *
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