Healthy By Tammy Registration and Waiver Form

Healthy By Tammy - Tammy Norman

Registration and Waiver Form

healthybytammy@gmail.com info@healthybytammy.com

Terms and Conditions

Please read and initial/sign below
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Of Birth*

MonthDayYear
Date
Emergency Contact *
Emergency Contact Phone Number*
Are you currently experiencing any of the following?*

AsthmaMuscular InjuryJoint InjuryPregnancyHigh blood pressureLow blood pressureDizzy/Fainting spellsEpilepsySeizuresDiabetesSurgery in the last 5 yearsAnything other medical condition your instructor needs to knowAnything to be discussed prior to class that your instructor needs to knowALL CLEAR - NO HEALTH ISSUES
Detail any items checked above*
Explain Injury or other:*
How did you hear about us? If referred please indicate who referred you.*
What is your primary interest in your session/yoga/seminar today?*

Weight LossFlexibilityStrengthRelieve StressOvercome Injury (if so explain below)Other (explain below)
Explain Injury to Overcome OR Other
Term & Conditions

Please read, initial/check and sign below:
All Sales Final*

Classes purchased are non-refundable and non-transferable for any reason.
Start/End Time*

Classes are scheduled for 60 minute blocks. If you arrive late or stop/start mid-class, class will still end at the scheduled time.
48 Hour Cancellation / Change Policy*

Classes can be rescheduled without penalty provided a minimum of 48 hours advanced notice is given. If less than 48 hours, then class will not be refundable or transferred.
Liability Waiver
(Please read carefully) Students take full responsibility for their own health and any illness or injury that may occur. In the case of suspension yoga (trapeze yoga), it is the students responsibility for secure professional installation and maintenance of their own suspension yoga (trapeze yoga) unit. Individual results may not match individual expectations. This is a safe practise space, we reserve the right to refuse admittance for any reason.

I , the undersigned student, accept and agree that I cannot and will not hold instructors or any employers or affiliates responsible/liable for any accident, illness, injury, death, or damages of any kind during or related to practice/class/seminars/or any interaction with Healthy By Tammy, it's owners or affiliates.

I, the undersigned, understand that Yoga or any information given by Healthy By Tammy is not a substitute for Medical Attention, Examination, Diagnosis or Treatment. I should consult My Doctor Prior to beginning any program. I recognize that it is my responsibility to notify my Instructor of any serious illness or injury before each class /session. If you have an existing medical condition or injury, make sure your doctor approves of yoga as a rehabilitation protocol. Your health is your responsibility, please take care and err on the side of caution.

I will not perform any postures to the extent of strain or pain (especially joint). If at any time during the session, you feel discomfort or strain, gently come out of the posture. You may rest at any time during the class. It is important that you listen to your body and respect it's limits on any given day.
I have read, understand & agree to ALL of the above terms & conditions and that I have been open and honest about my health.*

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Term & Conditions