Yoga Program Application Form
Program Dates: Every Monday for ten consecutive weeks October 4 - December 6
Time: 9:30am - 11:00am
Address: Hoofbeats Sanctuary 26 Fellowship Drive, Doonan
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Email *
PLEASE NOTE
Completing your application form does not guarantee that you will be offered a place in the program. We are expecting the program to be over-subscribed and we will try to schedule more classes to accommodate everyone. We will be running the program 4-6 times a year and you will be prioritised for a place in future programs if not offered a place in this round.
Your Name *
Your Email *
Your phone number *
Your age *
Please tell us a little bit about you and why you are seeking support through this type of program. This information is held in strict confidence - we use it only to help us to group people with similar needs and experiences together if the program is over-subscribed and we need to add more sessions. *
Are you confident that you can fully commit to attending all 10 sessions in the program? *
Required
Have you attended yoga classes before? *
Required
Do you have any injuries or medical conditions that we need to me aware of to keep you safe? *
Required
If you answered Yes above, please provide some details. *
Are you able to contribute toward the cost of your program? Please note that this does not affect whether or not you will be offered a place in the program. *
Required
RELEASE AND WAIVER OF LIABILITY
Because there are horses at the sanctuary that you may interact with during you visits, we ask that you sign the following waiver.
In consideration for being permitted to enter this property and participate in any way in horse activities, I, the undersigned acknowledge and accept that;• Horse activities can be dangerous and horses can act in sudden and unpredictable (changeable) ways, especially if frightened or hurt.• There is significant risk that serious injury or death may result from horse activities. I furthermore confirm I am aware of the obvious risks associated with activities involving horses and I knowingly and freely assume all such risks. I voluntarily participate at my own risk and assume sole responsibility for any injury, death or property damage I may suffer that arises from my participation in horse related activities.I understand and acknowledge the dangers associated with the consumption of alcohol or any mind altering drugs before and during the activity and take full responsibility for any injury, loss or damage associated with their consumption. I agree not to drink alcohol or take drugs prohibited by law before or during this activity.I agree to follow the directions given to me and that any misconduct or refusal by me to follow any direction can result in the CANCELLATION of participation in the activity and my immediate removal from the vicinity of any horse. I understand that any such non-compliance may result in injury, death and/or permanent disability and I agree to indemnify Kanyini Connections Ltd against all claims made by any person as a result of my failure to comply.I agree that I am solely responsible for my actions.I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS AND AGREE NOT TO Kanyini Connections Ltd, their volunteers, program facilitators, agents and/or employees, other participants, land owners, lessors of premises WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH or LOSS OR DAMAGE TO PERSON OR PROPERTY.I agree that this waiver will apply immediately and will cover all future visits to the sanctuary. *
Required
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