Health Declaration & Booking Form

Please fill out the following form in order to attend yoga classes. Payments are by direct bank transfers only.

Name

Mobile phone number:

Start date:

Which subscription/ Yoga Class have you chosen ?

Have you attended a yoga class before?

Yes

Do you have a medical condition?

Yes

Do not wish to declare

If you answered yes to any question, please elaborate. There are conditions (e.g. Heart disorders; Asthma; Epilepsy...) that require special attention. So it will be useful for your teacher to be aware of them. If you are unsure please consult your GP before commencing class.

I agree to take full responsibility for not exceeding my limits in the practce of Kundalini yoga and for any injury or discomfort I might experience.

Full name

Thanks for submitting!

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Health Declaration & Booking Form