Registration form for pregnancy yoga - strictly confidential
Due date and planned place of delivery:
Age of any other children
In this pregnancy have you experienced any of the following
Lower back pain / aching groins / sciatica
High or low blood pressure
Oedema / swelling
Please give details of any other health issue, surgery or injuries:
Have you practised yoga before?
Can I hold your personal details / contact information on computer / hard copy to comply with GDPR?
Can I contact you with information about other yoga and hypnobirthing courses?
How did you hear about this class/course?
Thank you for filling out this form
As far as I'm aware, I have disclosed to my yoga teacher all information regarding my health relevant to the practice of yoga during pregnancy. I take full responsibility for all applications of yoga I may practise during my yoga class, outside of the yoga classes during my pregnancy, in labour and after giving birth. I full understand that the recommendations, ideas or techniques expressed and described in yoga classes as well as in books and videos cannot be regarded as substitutes for the advice of qualified medical practitioners. Any uses to which the recommendations, ideas and techniques are put are at my sole discretion and risk.
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