Name *

First Name

Last Name

Agreement *

Please advise if you are pregnant or currently taking medication or have any injuries that should be made clear to the teacher. I declare that the above information is correct and I understand that yoga includes physical movements as well as an opportunity for relaxation. As in the case with any physical activity, the risk of injury may be present and cannot be entirely eliminated. I will not perform any postures to the extent of strain or pain. If I experience any pain or discomfort during or after class, I will stop performing a pose immediately and will inform the teacher. I will listen and respect the limits of my body on any given day and take a rest at any time during the class as needed. I understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment. I should consult a physician prior to beginning any activity program, including yoga. It is my responsibility to notify the teacher of any serious illness or injury before yoga class. I accept that neither the teacher, nor Madina Yoga is liable for any injury and I take full responsibility of my own actions, or damages, to person or property, resulting from taking the yoga class. I understand that Emotional Release Yoga is not a substitute for psychotherapy and counselling. In case of any strong emotions or old trauma resurfacing, I will seek professional help from a psychotherapist, psychologist, or counsellor. All information on this form is kept confidential.

I agree with the terms listed above