Please list any injuries, surgeries, ailments or medications, current or past, that the yoga teacher should be aware of (e.g. current pregnancy, high blood pressure, diabetes, back pain, etc). If irrelevant, please write "N/A"

DISCLAIMER: If at any time during the 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.

I, the undersigned, understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment. I should consult a physician prior to 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 taking the class. Those under 18 years of age must have this form also signed by a parent or guardian.