Registration Form - Kate Shepherd Yoga

Name*

First NameLast Name

Your email address:*

example@example.com

Email 'Opt In'

Have you done Yoga before? If so, for how long? And do you know what type(s) of Yoga you have experienced?

Do you have any injuries and/or other health issues I should be aware of?

Which of the following are true for you? Please select ALL that apply.

What would you like to get from a Yoga class?

How did you find out about the class?

Further Information

If you are pregnant, have high or low blood pressure, osteoporosis, or have a detached retina please make sure to talk to me before class or email me at kate.shepherd@shepherdwellbeing.com so that I can make appropriate adjustments to the class for you

*In providing your email address and in ticking the opt-in box you are electing to subscribe to the Kate Shepherd Wellbeing newsletter email list, this is simply used to keep you informed. We will never share, rent or sell your personal information to third parties and you can unsubscribe at anytime. A full privacy policy with GDPR compliance is available at https://bookwhen.com/kateshepherdyoga

Disclaimer

You agree that any information, instruction or advice obtained from Kate Shepherd or her associate teachers may NOT be used as a substitute for your Doctor's advice or treatment and will be used at your own risk.

Signature*

Please add your signature in the box.

Date*

Day (DD)Month (MM)Year (YYYY)