Abby Yoga Health Questionnaire

Name *

Last Name *

Address *

Phone-Cell *

Home *

Work

Email *

Are there any physical conditions that the teacher/therapist should know about? Please mention past injuries/ongoing difficulties. *

If you are Pregnant, please inform how many weeks

Do you have previous Yoga experience?

What other kind of activities do you engage in?

The teacher will do his/her best to deliver a safe class; it is the student’s responsibility to work at a level that will not cause damage or injury. Please update the teacher on any conditions that you have now and that might develop during the yoga session.

Release/Waiver

I understand that Yoga classes, Holistic treatments, massage, reflexology, and the yoga studio facilities may involve inherent risks including but not limited to, physical activity which may result in bodily injury in consideration of Abby Yoga Studio accepting this registration/participation.

I for myself, my heirs, executors, administrators and assigns, release and hold harmless Abby yoga studio from any claims, demands, damages, actions or causes of actions arising out of or in consequence of any loss, injury or damage to my person or property incurred while practicing Yoga or receiving holistic treatments at any time or place and without limiting the generality of the foregoing specifically, while attending or participating in Yoga classes, Yoga workshops or other meetings, notwithstanding any such servants, agents, employees, visiting-substitute or seasonal teachers.

I acknowledge that Abby Yoga Studio and its Principals and teachers bear no liability for accidents or injury incurred by myself or any family member while engaged in Yoga classes or any other activity on or off the premises.

I have read this document carefully. I understand that signing this document may affect my legal rights, including the right to sue.

Date From

and onward for as long as I continue yoga studies in the studio or online classes with Abby Yoga Studio.

Captcha *