• Yoga Class Registration Form

    My first class at Mindful Mandi
  •  -
  •  -  -
    Pick a Date
  •  -  -
    Pick a Date

  • Returning student: skip page 2, proceed to page 3 for class selection.

    First time student: complete page 2, then proceed to page 3 for class selection.

  • Liability Waiver

    I represent and warrant that I am in good physical health and do not suffer from any medical condition(s) that would limit my participation in the classes offered by Mindful Mandi.

    If I do have any medical condition, I take full responsibility of my activity associated with my participation.

    I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any of the yoga and/or fitness classes offered by Mindful Mandi.

    I understand the risks associated with the activities offered by Mindful Mandi and I agree to follow all instructions so that I can safely participate in yoga classes.

    I acknowledge that participation in yoga classes or any other fitness exercise classes exposes me to possible risks of personal injury.

    I am fully aware of these risks and hereby release Mindful Mandi and/or any other persons who may teach at Mindful Mandi from any and all liability, injury lawsuits while on premises, negligence, or other claims arising from, or in any way connected with my participation in their yoga classes and any other exercise classes offered by them.

    I will practice safely and only to my personal ability. All movement will be at my own discretion.

    I give permission for Mindful Mandi to release any photo I may be in on any social media or advertising site.

    I have read the above release and waiver of liability and fully understand its content. I am legally competent to sign and voluntarily agree to the terms and conditions stated above.

    Please practice mindfully and enjoy the benefits of practicing yoga with Mindful Mandi.

    I will electronically sign after reading this and by doing so I agree to all the terms stated in this document.

  • I, , have fully read the liability waiver for Mindful Mandi. I do not have any questions or concerns. If I do have questions or concerns I will not sign this document (on page 3), and address them before submitting my registration and document.

  • Please select the date your planning/requesting to attend below.

  •  -  -
    Pick a Date
  • prev next ( X )






    Subtotal   $ 0.00 Tax   $ 0.00 Total   $ 0.00
  • Clear

  • Please click one of the PayPal options to complete payment and submit the form.

  • Should be Empty:
Jotform Logo
Now create your own JotForm - It's free! Create your own JotForm