Waiver Form

    Your Details

    First name

    Last name



    Getting to know you

    Have you practised yoga before?

    If yes, for how long?

    Any limitations / injuries / allergies?

    Do you currently have any numbness / pain in any of the following? "(tick all that apply)"

    Emergency contact

    Contact name

    Contact number


    If any time during this class, you feel discomfort or strain, gently come out of the posture.You may rest at any time during the class. It is important in yoga that you listen to your body, and respect its limits on any given day.

    Those under 18 years of age must have this form signed by a parent or guardian.

    I, the undersigned, understand that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including yoga. I recognise that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I will not perform any postures to the extent of strain or pain.

    I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from me taking the class.

    Your name:

    Your signature :