Participation Form

Class / Workshop Participation Form

Please complete the below form to the best of your knowledge. Similarly, should there be any changes in your medical circumstances, please advise us accordingly.

Client Contact Details

First Name

Surname

House Name / Number and Address Line 1

Address Line 2

Postal Town or City

County

Postcode

Phone

Would you like to receive Yogadia updates by e-mail?

I'm happy to receive e-mails from Yogadia

Emergency Contact

Name

Phone

Yogadia uses the above data for informing you of class schedules and for getting in touch with an Emergency Contact should the need arise. This includes when arranging for another qualified teacher to provide a class. No personal information is shared elsewhere. At any point you may request to see, alter, rectify or delete you information and it is renewed and update annually. If you no longer participate in Yogadia classes, you information will be destroyed.

Medical Information

Date of Birth

Please tick if you are Pregnant

Have you got any medical conditions or injuries? (Please list below)

Please be aware that Yogadia instructors do not assume any responsibility for determing your medical fitness to participate in any class, nor assumes any responsibiltiy for any injuries to you or loss of property by you in or about the class premises. It is the responsibility of the student to inform their instructor of any medical conditions which should be taken into consideration when practising yoga.

PLEASE CONSULT YOUR DOCTOR IF YOU ARE IN ANY DOUBT ABOUT PRACTISING YOGA AND ADVISE YOU INSTRUCTOR OF ANY CHANGE OF CIRCUMSTANCES

I understand that to participate in classes run by Yogadia or by nominated yoga instructors I will take full responsibility for myself and will not practice beyond my limits in any of the yoga practices and agree to the conditions above.

I agree