Yoga for High Schoolers

Participant's Name

First NameLast Name

Participant's Phone Number

Please enter a valid phone number.

Participant's Email

example@example.com

Participant's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Age

Date of Birth

Date

If below 18 years old (minor), please enter name of parent or guardian

First NameLast Name

Parent / Guardian Phone

Please enter a valid phone number.

Have you done yoga or any workout program before?

YesNo

If yes, can you please provide more details?

Do you have any physical limitations or any health issues/conditions that we should be aware of?

YesNo

If yes, please provide more details.

Do you have any of the following?

I, First NameLast Name would like to participate in a yoga class being offered at St. John's Episcopal Church. I fully understand that yoga is a physical activity that may or may not cause physical injury. I agree to declare any health issue, conditions I may have before signing up for the program. In the event that poses might be uncomfortable, any suggested modification can be discussed to me directly in a respectful manner. If there's any strain or fatigue, I can come out of the pose to rest and understand that each and every one has its own physical limitations. I fully recognize that any injuries sustained from all the physical activities will be my responsibility. Therefore I release St. John's Episcopal Church and the instructor of this yoga class of any liabilities.I have read and fully understand the terms of the agreement/waiver and accept all of it.

Participant's Signature

Date Signed

Date

Parent/Guardian Name

First NameLast Name

Parent/Guardian's Signature

Date Signed

Date

Yoga for High Schoolers - beginning 9/21

Consent Agreement