Enrolment Form for Yoga Maleny | Maleny Yoga Centre

Maleny Yoga Centre

Yoga with Maree

Enrolment Form

All new students must submit this form before attending their first class

All information provided is strictly confidential 🙏 Maree

First name

Last name

Mobile number

Birthday

Day

Month

Year

Emergency Contact number

Have you practiced Yoga before. For how long & what form?

What do you want to achieve from your classes?

Are you trying to fall Pregnant or are you pregnant? Are you less than 7 months post-natal? Are you undergoing IVF treatment. Please be specific.

Have you been Hospitalised in the last 6 months? Please be specific.

Have you a Medical Condition - either Acute or Chronic? Please describe in detail.

Have you any Injuries - either Acute or Chronic? Please describe in detail.

Are there any specific movements that are Restrictive or Painful? Please describe in detail

Please acknowledge & sign below

I declare that the information provided is accurate & complete

I understand yoga is a physical activity & participate at my own risk

Signature

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