First Name*

Last Name*

Your email*

Phone*

Date Of Birth*

Emergency Contact Name*

Emergency Contact Number*

Have you practiced yoga before?*
YesNo
If Yes how long for?

What are you looking to gain from the sessions

Please inform us of any medical conditions the instructor should be aware of*

I understand that it is my responsibility to consult my GP prior to enrolling for yoga classes. I also understand that yoga is not a substitute for medical attention examination diagnosis or treatment. I recognise that it is my responsibility to notify my yoga teacher of any serious illness or injury before every yoga class. I will not perform any postures to the extent of strain or pain. If at any time during the class I feel discomfort or strain I will gently come out of the posture. I accept that neither the teachers nor SSW are liable for any injury or damages to me or my property resulting from taking the class or in the future and I use the SSW premises at my own risk
Parent/Guardian's Name if applicant is under the age of 18