New Student FormWelcome to my yoga classes Name * First Name Last Name Email * Would you like to sign up to the mailing list? * Yes Please! No thank you. Phone Country (###) ### #### Have you ever practiced yoga before? Yes No Yes - but still very new to yoga Other - pilates etc Checkbox 1 Do you have any injuries or medical history you feel its important your instructor knows about before class: * No Yes Text Area * If yes please give any details you feel necessary. By ticking this box I acknowledge that I understand that yoga includes physical movements as well as an opportunity for relaxation, stress and muscle release. As in the case with any physical activity, the risk of injury, even serious of disability, is present and cannot entirely be eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity and ask for support from the instructor. I assume full responsibility for any and all injuries may occur through participation. heckbox 2 * I agree By ticking this box I acknowledge that yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended for certain medical conditioned. I confirm that I alone am responsible to decide whether to practice yoga. I hereby agree to irrevocably release and waive any claims that I have no of hereafter may have against Amelia and/or Amelia Grace Yoga. * I agree Date Please enter the date you agreed to the terms and submitted this form. MM DD YYYY Under 18? If participant is under the age of 18 parent/guardian please sign below with your name. Thank you!