Yoga & Mindfulness Registration and Waiver Form

Zen Yoga, Restorative Yoga, Meditation & Mindfulness
I am interested in attending:

Zen YogaRestorative YogaGentle YogaMeditation and MindfulnessOther
Name

First NameLast Name
Email
example@example.com
Phone Number
Name of Emergency Contact
Phone Number
Do you have any previous injuries or health conditions that may affect your ability to take part in yoga or meditation classes? (please comment below)
Please tick any that apply

I need to use a chair in classI need to make adjustments in class (for the reasons stated above)I need to make adjustments in class (due to being pregnant)I have a health condition but I have checked with a health professional and I am fine to take part in yoga and meditation classes.
If at any time during a yoga or movement session, you feel discomfort or strain, gently come out of the posture.

Listen to your body and rest at any time during the class.

If thoughts, feelings and emotions come to the surface, rest, take it easy and allow them to pass.
Disclaimer (Please Read Carefully)

I understand that yoga, meditation or mindfulness are not substitutes for medical attention, so I should consult a health professional if I have any concerns.

I will not perform any postures that cause strain or pain.

I accept full responsibility for my health during yoga, meditation and mindfulness classes and I will inform my teacher of any changes to my health.

I agree to allow Create Harmony to keep my details for the purposes of being able to contact me and to be prepared for each session.

I know that my email will be added to the newsletter mailing list to keep me informed about any future classes, but I can unsubscribe at any time.
Date

MonthDayYear
Date
I agree to all of the above and that I have been open and honest about my health

Please tick
Should be Empty: