Online Yoga Class Registration Form

Peckham Community Yoga Registration

Beginners Hatha Yoga | Mondays 6.30pm | Budgens Pomeroy Street, Peckham/ New Cross
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Which classes would you like to register for?

Mon 12th Jan 6.30pmMon 19th Jan 6.30pmMon 26th Jan 6.30pmMon 2nd Feb 6.30pmMon 9th Feb 6.30pm
Have you completed a registration form for Peckham Community Yoga before?

NoYes

About You
Do you have any health or mobility conditions that I should be aware of to ensure a safe and enjoyable experience for you?*
If yes, please provide brief details
It’s your responsibility to consult your GP before beginning a yoga practice, and seek medical consent where necessary.*

I understand
Which statement best describes your current yoga practice?*

I am new to YogaI practice regularlyI have practiced Yoga before, but not for a while
What are you hoping to achieve from signing up to Peckham Community Yoga?
Don't worry if you can't think of anything yet, we'll explore you sankalpa (your intentions) during the class
Name of Next of Kin*

First NameLast Name
Contact number for Next of Kin *

+44Phone Number
Are you happy to be included in any photos that might be used for future promotional purposes?*

YesNo
As this is a not for profit community class, you'll need to bring your own yoga mat and blocks and straps.

I understand

Yoga Participation Waiver Form
By signing this waiver, I agree and understand the following:

1. I understand that classes may be physically strenuous and I participate in them voluntarily with the full knowledge that there is risk of personal injury.

2. I agree and understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment.

3. I have been advised to consult with my GP prior to joining a yoga class.

4. I recognise my responsibility to notify my teacher of any serious illness or injury (including pregnancy) before every yoga class.

5. In case that instructors provide physical adjustments, I understand that I have the option to opt-out by letting my instructor know my wish not have physical adjustments.

6. I will not perform any postures to the extent of strain or pain.

7. I accept that the teacher may in their sole discretion prohibit me from participating in a yoga class and that I must comply with all of the instructions in relation to the classes.

8. I accept that Ji Yoga, the teacher nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of the class.

9. I agree that neither I, nor my legal representatives will sue or make any other claims whatsoever, against Ji Yoga for any personal injury, property damage/loss, or wrongful death, whether caused by negligence or otherwise.

10. By signing this form, I hereby represent and warrant that I am physically fit and capable to participate for yoga classes, workshop, or activities. I agree and legally bind myself, with full understanding to the contents and meaning of the provisions above.

11. I declare that I am over 18 years of age and fully capable in giving my consent.
I have read and agree to the waiver above
Community Ethos

This class is rooted in the spirit of community, designed to make traditional yoga accessible to all, regardless of background or experience.

While I offer these sessions for free, if you are in a position to give, I invite you to donate £5 to my chosen charity, Medical Aid Palestine ❤️.

Your contribution is entirely voluntary, with no questions asked—these classes are about coming together to practice, learn, and uplift each other.

Donate here
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Peckham Community Yoga Registration

About You

Yoga Participation Waiver Form