Enrolment Form | malenyyogacentre

Please complete the form & submit before coming to class

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

& also has an extra field of protection applied on all information🙏 Maree

First name

Last name

Mobile number

Birthday

Month

Day

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 had approval from your Medical Practioner to commence Yoga classes?

Have you a Medical Condition - either Acute or Chronic? Please describe in detail. Do you have approval from your Medical Practioner to commence Yoga classes?

Have you any Injuries - either Acute or Chronic? Please describe in detail. Do you have approval from your Medical Practioner to commence Yoga classes?

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

Signature field is empty.