New Student Questionnaire

Please complete the following questionnaire. The information I receive will allow me to plan the yoga classes more effectively to suit your own needs and interests.

Any information you provide will be treated in the strictest confidence and will not be disclosed to any individual or organisation.

New Student Questionnaire
Have you ever practiced yoga before? *

Your Health

The following information is required to ensure your safety. Whilst yoga may be practised by the majority of people, there are certain conditions which require special attention. If you are unsure, please consult and seek permission from your GP before commencing yoga.

The following conditions require specific modifications to your yoga practice. Please tick if any of the following apply to you. If you tick any, please provide further details below.
The following conditions may affect your yoga practice. Please tick if any of the following apply to you. If you tick any, please provide further details below.

DECLARATION

(Please read the following and sign below)

I confirm that the above information is correct.

I take full responsibility for my health during yoga classes

I understand that it is my responsibility to:

  • Check with my GP beforehand if I have any concerns about my ability to practice yoga
  • Advise the teacher of any change in my medical information or other, which may be relevant before the start of each class
  • Follow the advice given by my GP and yoga teacher
  • Take full responsibility for not exceeding my physical limitations and for any injury that might occur as a result
  • Only do what feels comfortable in class and not to work in pain
  • To inform the teacher if I experience any difficulty in class
  • To practice mindfully and safely

I acknowledge that participation in yoga classes exposes me to a possible risk of personal injury. I am fully aware of this risk and hereby release MBS (Kirsty Goddard-Holmes) from any and all liability, negligence or other claims arising from or in any way connected with my participation in yoga classes.