How did you hear about this class? blanks* What are your primary goals for this class? blank* Please list any existing or past conditions (high blood pressure, back/neck pain, knee pain, low blood pressure, hip pain, anxiety/depression, glaucoma, pregnancy (current), low blood sugar): Type a label* **Please list any other health concerns, injuries, allergies or medical conditions:Type a label*
During interactions with alpacas or donkeys, yoga participants are subject to risks, such as: injuries caused by kicks, strains, sprains, cuts, further injury, disability or death.
In any physical activity, risk of serious physical injury is possible. Yoga and other activity is no substitute for medical diagnosis and/or treatment. The student assumes the risk of yoga or farm related injury and releases the teacher(s) and Kensington Prairie Farm from any liability claims.I, First Name* Last Name* (please print name), am participating in classes with Pavan Ubhi at Kensington Prairie Farm and I have read this Personal Health Questionnaire and Waiver thoroughly. I am aware of the physical risks involved with exercise and being around animals and understand it is my personal responsibility to consult with my doctor regarding my participation. I have no medical conditions, that I am aware of, which would prevent me from taking part in classes or workshops, and I assume responsibility for any risk or injury I may sustain as a result of my participation. I have read the above release and waiver of liability and understand its contents. I understand that it is my responsibility to find a pace that suits me. I agree to the terms and conditions stated above.
On this date: Date* 2025.