Stouffville Yoga Life

Waiver Form

 

**Please note, all of the information on this form is kept confidential.

 

REGISTRANT DETAILS:

 

Name: __________________________________________________________________________

Address: ________________________________________________________________________

City: _________________________ Prov:______________ Postal Code:_________________

Email: __________________________________________________________________________

Phone:__________________________________________________

EMERGENCY CONTACT: __________________________________________________________

EMERGENCY CONTACT PHONE NUMBER: ___________________________________________

Have you practiced yoga/pilates before? YES/NO (Please circle)

If YES, for how long? ______________________________________________________________

 

If at any time during the class, you feel discomfort or strain, gently come out of the posture or exercise. You may rest at any time during the class. It is important in yoga/pilates that you listen to your body, and respect its limits on any given day.

 

I, the undersigned, understand that yoga/pilates is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including yoga and pilates. I recognize that it is my responsibility to notify my teacher of any physical condition that may affect my abilities before every class. I will not perform any postures or exercises to the extent of strain or pain.

 

I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of the class. Those under 18 years of age must have this form signed by a parent or guardian.

 

 

 

___________________________ __________________________ ______________

Name (Print) Signature Date

 

 

 

__________________________ __________________________ _______________

Parent/Guardian Signature Date

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OPENING HOURS

 

MONDAY-THURSDAY 9:00AM-9:00PM

FRIDAY 9:00AM-6:00PM

SATURDAY 8:30AM-12:00PM

SUNDAY ​8:30AM-5:30PM

 

   © 2015 Stouffville Yoga Life all rights reserved
ALL MATERIALS AND CONTENT IS PROVIDED FOR INFORMATIONAL PURPOSES. WE MAKE NO REPRESENTATION, GUARANTEE OR WARRANTY REGARDING THE COMPLETENESS, ACCURACY, FITNESS, EFFECTIVENESS OR APPLICABILITY OF ANY INFORMATION, MATERIALS OR CONTENT.

CONTACT​ US

42 SOMERVILLE ST.

STOUFFVILLE, ON L4A 1G6

905-591-5433

info@stouffvilleyogalife.com