NEW MEMBERS REGISTRATION

Ki Yoga is safe and beneficial when practiced with integrity. All possible care will be taken by
your Ki Yoga teacher to ensure your well being throughout the class. However, they cannot be responsible for improper practice at any time.

It is your responsibility to inform your teacher before the start of each class of any recent
injury, illness, surgery, pregnancy or impediments to your practice.

The following information is designed to help your teacher understand your needs, and contact you if necessary.

Please feel free to discuss any health related issues with your Ki Yoga teacher

Your Name :

Birthday :

Gender : Male Female

Post Code :

Your Email

Phone(Home Work ) :

Mobile :

Occupation :

What is your level of experience with Yoga?
Beginner Intermediate Very experienced

Are you taking any medication?
(Please supply details) :

Have you any injuries or impediments to your practice?
(Please supply details) :

Are there any other details you would like to make your teacher aware of? (Please supply details) :

How did you find out about this Ki yoga class?

Flyer Friend WAVES Community Centre Google Other

AGREEMENT

I understand that the instructions given during the class are intended only as a guide. It is therefore my responsibility to adjust my practice according to my limitations to ensure that no personal injury occurs.

I hereby declare that the teacher will not be liable for any injury occurring in connection with the Ki Yoga class.

I Accept:

Please enter the above characters to prove you are a budding yogi!!

Dated:

(All information supplied herein is received and stored with your complete confidentiality and will not be supplied to any other parties)

"Inspiring Wellbeing In The Community"