Yoga registration form: please complete, print and bring to your first class.
| Name | |
| Address | |
| Phone | |
| Occupation | |
| Yoga experience | |
| Other sports, activities | |
| List pre-existing or current medical conditions, injuries and/or surgeries |
|
Please answer if pregnant |
| Due date | |
| Currently how many weeks | |
| Your date of birth | |
| Who is your doctor? | |
| Has Dr. OK'd yoga for you? | |
| Where will you deliver? |
| YOGA RELEASE AND WAIVER (1) I recognize that yoga may require some physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved. (2) I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the yoga class. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in the yoga class. (3) In consideration of being permitted to participate in the yoga class, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program. (4) In further consideration of being permitted to participate in the yoga class, I knowingly, voluntarily and expressly waive any claim I may have against Purple Yoga Hawaii and its instructors for any injury or damages that I may sustain as a result of participating in the program. (5) I, my heirs or legal representatives forever release, waive, discharge and covenant negligence or other acts. (6) I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above. |