Events | emmajaulin

PLEASE COMPLETE & SUBMIT BEFORE YOUR FIRST CLASS

*First Name

*Last Name

*Email

Today's Date

*Emergency Contact Name

*Emergency Contact Number

Date of Birth

*Which classes are you attending?

Please describe your yoga practice, including experience and style of classes previously attended.

If prenatal: this your first baby? Please note your due date.

Have you had any complications during your pregnancy or after birth?

Is there anything else you would like us to know?

*Consent of Agreement: • I understand it is my responsibility to consult with a physician prior to and regarding my participation in these yoga classes.

I accept

*I agree to assume full responsibility for any risk, injuries, or damages known or unknown that might occur as a result of the yoga classes at the Health House LTD with Emma Jaulin & cover teachers.

I accept

*• I understand that it is my responsibility to keep the instructor informed of changes in physical abilities, and choose variations of postures that work within my body and strength.

I agree

*• I accept full responsibility for my body & pregnancy & acknowledge that only I am in control of my body and am aware & responsible for all physical risks.

I agree

*• I fully release Emma Jaulin & cover teachers free from any liability, including financial responsibility for injuries, regardless of whether injuries are caused by negligence.

I agree

PRE & POST NATAL LIABILITY WAIVER

PLEASE COMPLETE UPON BOOKING

FOR CLASSES AT HEALTH HOUSE LTD

EMMA JAULIN

LIFESTYLE & BALANCE