Registro de Clases de Yoga Online

Name

First nameLast name

When is your due date?

How many weeks pregnant are you?

Birthdate (mom)

Fecha

Do you have medical clearance to practice yoga?

YesNo

Email

example@example.com

Telephone (optional)

City where you live (optional)

Emergency contact

First NameLast Name

Emergency contact phone number

Have you practiced yoga before or any other exercise?

YesNo

If you answered yes, which type or exercise have you have practiced and for how long?

Do you have any cardiovascular condition?

YesNo

Do you have any respiratory condition?

YesNo

Do you have asthma?

YesNo

Do you have any other medical condition that you want to share? If you do please explain. All the information given is strictly confidential.

Expectations for this class

"Yoga with Lau" is a space that promotes physical activity through yoga, specializing in pregnant/expecting mothers and mothers with babies who want to join the practice of yoga and meditation.

The participant/client and the instructor accept and understand that it is a program that requires physical activity and that may cause injuries.

The participant/client agrees that she is medically authorized to practice yoga and physical activity during pregnancy or for herself and her baby.

The participant/client releases the yoga instructor from any injury that occurs in the yoga class to her or her baby.

I affirm that I have read and understand all of the information in this agreement, that I am over the age of 19 and I am legally responsible for my own decisions/actions.

By signing, I accept the terms of this document.

Agreement date

Date (month-day-year)

Participant/Client Signature

Online Yoga Registration

Personal Information

Personal Goals

Consent agreement