Yoga Consent Form
Classes are held at Serenity Now Yoga studio by Nicole Balogh, Certified Yoga Teacher
Name *
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Email *
Your answer
Please indicate any health or medical conditions that you believe may assist us in addressing your needs, or that might prevent you from participating fully in classes. *
Your answer
What do you hope to gain from classes?
Your answer
Are you comfortable with hands on assistance?
I understand that part of the risk of undertaking any activity or program is relative to my own state of fitness or health (physical, mental or emotional). I understand that I am free to withdraw from, reduce or modify my involvement in any program activity and I realize that I should do so upon recognition of any signs of lightheadedness, fainting, chest discomfort, leg cramps, nausea, etc. I hereby agree to be fully responsible for any injury or mishap that may result from my participation in Yoga classes and that I will not hold the instructors, or the facility, liable for any such mishap or injury, should this occur. *
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