New Student Health Declaration Form
Thank you for your interest in joining my Yoga classes it would be great to see you on the mat! Prior to attending any class I need to obtain some general health information from you.
Email address *
First Name *
Surname *
How did you hear about Yoga2Restore?
What would you class your experience in yoga as?
Clear selection
If you have practiced yoga before, what style do you enjoy?
Have you any medical conditions or injuries that you think I should be aware of? *
If you have a medical condition that you think I should be aware of please provide more information below:
Health and Information Declaration
By signing the below, I confirm that I acknowledge:

• That all exercise involves a risk of personal injury, and agree to take responsibility for my health and well-being in relation to your yoga classes.
• To the best of my knowledge, I suffer from no medical or physical condition or disability that will or might increase the normal risks associated with exercise and/or my doctor has approved my participation in yoga classes.

I will inform you as soon as possible if:

• I suffer from any new injury, illness or other medical condition
• I feel any pain or discomfort during a yoga class or
• I feel that any exercise included in a yoga class would be unsafe or uncomfortable for me.

Yoga2Restore uses a booking system, this is a free system that allows you to book your classes and I then send out the Zoom link about an hour before the class. By signing this you also agree to allowing me to use your email address and name within the app to allow for registration and record keeping. All classes will need to be booked via my booking system

You also confirm that you are happy to receive information from me regarding classes, newsletters and courses I will be running. I will not overload your inbox and you can opt out at any time.
Signature *
Thank you for taking the time to complete this form
I will send you details on how to make payment and set you up on my booking system shortly. If you have any questions, please do not hesitate to contact me via email at
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