DURHAM STUDIO ENLIGHT - Yoga Registration Form
In consideration of my being permitted to participate in Yoga activities at DURHAM STUDIO ENLIGHT LLC, I, for myself, my heirs, legal representatives, and assigns, do hereby release said activity, the activity instructor, Jessica Sheppard, and any person responsible for organizing and/or overseeing the activity at the location where the said activity will be conducted, from all suits, claims or demands of any kind, which may result from any injury, loss or damage of any kind, arising out of or in connection with my participation in said activity.
Participant Full Name (First Last) *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Age or Birthday *
Your answer
Sign up for Integral Yoga 75 minute class
Sign up for Private Instruction - I will contact you to set up an appointment. $75 per hour
10% Discount Qualification
Emergency Contact (Full Name and Phone Number)
Your answer
Employer and nature of work
Your answer
What benefits do you expect to realize from practicing yoga?
Your answer
Previous yoga experience - style, duration, etc.
Your answer
Any other sports or physical activities you participate in?
Your answer
Any medical conditions the instructor should be aware of? (including high blood pressure, past surgeries, serious illness, etc.)
Your answer
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