New Student Contact Information & Disclaimer
Must be completed by all students with Sarah Powell Yoga Ltd.
Email address *
First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Address *
Your answer
Mobile phone number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Mobile Phone Number *
Your answer
Please tell me about your yoga experience?
Tick One
Complete beginner (never practiced yoga)
Starting back after a break from yoga
Some experience (less than 5 years)
Many years of experience (5+ years)
Looking for Level 2 (inversions & handstands!)
Yoga Teacher looking for CPD hours
Looking to become a Yoga Teacher
Injuries and Medical Conditions *
Your answer
How did you find out about Sarah Powell Yoga?
Tick One
Word of mouth
Google or search engine
Flyer
FaceBook advert
Instagram
Other
Privacy
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 Sarah Powell Yoga Ltd. and will only used for the purpose of correspondence with you.
Liability Release
I, the participant, acknowledge the following:

- Yoga involves some physical activity which involves 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 and medical conditions on this registration form
- I understand Sarah Powell and staff have a duty of care to uphold and outside of that duty of care, any injuries or loss are my responsibility.

I hereby release Sarah Powell from liability arising from injury or loss outside of her duty of care.
I have read, understand and agree to the liability release *
Required
A copy of your responses will be emailed to the address you provided.
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