Personal Details
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Name
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Email
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Phone Number
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Active Whats App Number
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Date of Birth
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MM
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DD
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YYYY
Session
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6:00 AM - 6:45 AM PCOS/PCODS Workshop
8:00 AM - 8:45 AM PCOS/PCODS Workshop
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Health Condition
High / Low Blood Pressure
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Cardio Vascular Disease
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Neuro-muscular disorder
Recent Surgeries/Physical Injuries/Others (Please specify below)
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Weight
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Referred By:
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City
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Address
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Emergency Contact Name
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Relationship with Emergency Contact
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Emergency Contact Phone Number
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How did you find us?
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Consent and Terms and Conditions
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We understand that it is our responsibility to consult a physician prior to participating in sessions. We warrant that all family members enrolled are physically fit and do not have medical conditions which would prevent us participating in sessions. We recognize the various suggested poses should be approached in a gentle fashion. If any movement brings discomfort, We know to modify the pose as deemed necessary to our physical needs. We agree to assume full responsibility for any injuries sustained to any family members enrolled. We have read and fully understand this consent and accept its contents.
I read and accept all the terms and conditions.
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