Yoga Registration and Intake Form

Yoga Registration and Intake Form

Please complete this form to register for yoga classes and provide important health and contact information.
Participant Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Do you have any injuries, medical conditions, or physical limitations we should be aware of? If yes, please describe.
YesNo
Yes, regularlyYes, occasionallyNo, I am new to yoga
What are your goals or expectations for joining the yoga class?
Booking & Cancellation Policy

Payment for private sessions and series is due at the time of booking. Due to the limited size and intentional structure of our offerings, we are unable to provide refunds. In the event of an emergency, the instructor may, at their discretion, offer a class credit.If a series is canceled by the instructor, payments will be fully refunded or applied to a future series, according to your preference.

Please intial to agree.
Initials of Particpants*
Yoga Participation Agreement & Release of Liability
Please read the following carefully.

I understand that yoga includes physical movement, breathwork, and relaxation practices intended to reduce stress and relieve muscular tension. As with any physical activity, there is a risk of injury, including serious or disabling injury, which cannot be entirely eliminated.

I agree to listen to my body and acknowledge that it is my responsibility to modify or discontinue any movement or activity that causes pain or discomfort. I will inform the instructor if I need assistance or support.

I understand that yoga is not a substitute for medical advice, diagnosis, or treatment. I affirm that I am in good physical condition and have consulted with a licensed physician regarding any medical concerns that may affect my participation. I will inform the instructor of any medical conditions, injuries, limitations, pregnancy, post-natal status, or post-surgical recovery prior to participation.

By participating in yoga classes or sessions at Luminous Soul Center for Well Being, I voluntarily assume full responsibility for any physical, mental, or emotional effects resulting from my participation.

I hereby release and forever discharge Luminous Soul Center for Well Being and all instructors from any and all claims, liabilities, or demands arising from my participation in yoga classes or sessions, now and in the future.

I have read, understood, and agree to the terms of this Agreement and Release of Liability.
Signature of Participant*
Date of Signature*

MonthDayYear
Date
How did you hear about our yoga classes?
Should be Empty: