Name ……………………………………………………………………………………………………………………………………………………..

Email ………………………………………………………………………………………………………………………………………………………

Mobile Phone Number:……………………………

Welcome to Yoga.

As a Yoga teacher I am grateful of your presence here. My hope is that we will grow in yoga together.

Data Protection : PLEASE READ AND SIGN BOTH SIDES OF FORM

By signing this form you are giving Marella Fyffe Yoga permission to send you emails or texts with information about upcoming yoga, mindfulness, meditation and other events. We will then send you out a welcome email with a link to add yourself to our database (I know you have already filled in this form ; however this is a belt and braces request to be absolutely certain my mailing list conforms with GDPR legislation) it will take you about 30 seconds to read the form and sign it . If you choose not to opt in your contact details will no longer be held....and I will be sad to say goodbye  :-)  Your information will not be shared with anyone else ever. Please read our data protection policy which you will receive with this form.

*Are you ok with us using any photos that we may take of you which may be used for adver-tising? Your name will not be attached .

Please circle YES or NO

Questionnaire

Have you any illness, injury, or recent post operation history? Please describe…………………………………………………………………………………………………………………………..

Do you suffer from high blood pressure …………………………………………………………………………..

Are you pregnant ……………………………………………………………………………………………………………………….

Do you have any experience in yoga?……………………………………………………………………………………

Marella Fyffe Yoga

I hereby agree to the following

1. That I am participating in the Yoga classes or any other exercise programmes offered by Marella Fyffe (or an instructor at The Bamboo Loft Yoga Studio) during which I will receive information and instruc-tion about yoga, physical exercise or health. I recognise that exercise requires physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.

2. I represent and warrant that I am physically fit and I have no medical condition, which would prevent my full participation in these yoga classes, health programmes or workshops.I understand that it is my re-sponsibility to consult a physician prior to and regarding my participation in the yoga classes, health pro-grams or workshops offered by Marella Fyffe or any instructor at The Bamboo Loft Yoga Studio if I have any doubts about my physical fitness or medical condition.

3. If I am pregnant I understand that I participate fully at my own risk and that of my unborn child/chil-dren and that it is my responsibility to tell Marella Fyffe or any instructor at the Bamboo loft prior to taking yoga classes.

4. In consideration of being permitted to participate in the yoga classes, health programmes or workshops, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the programmes offered by Marella Fyffe or an instructor at The Bamboo Loft Yoga Studio

5. In further consideration of being permitted to participate in the yoga classes, health programmes or workshops, I knowingly, voluntarily and expressly waive any claim I may have against Marella Fyffe or any instructor at The Bamboo Loft Yoga Studio for injury or damages that I may sustain as a result of par-ticipating in these programmes.

6. I understand that from time to time during yoga classes, the instructor may physically adjust a student’s form and posture. If I do not want such physical adjustments, I will so inform the instructor at each class I attend. I also acknowledge that if I do wish to receive such adjustments, it is my responsibility to inform the instructor when an adjustment has gone as far as I desire at that time.

7. Please Sign I ______________________________ hereby take full and sole responsibility from any liability of loss or damage to personal property associated with yoga classes or any other events.

8. I, my heirs or legal representatives forever release, waive, discharge and covenant not to sue Marella Fyffe or The Bamboo Loft or its employees for any injury or death caused by their negligence or other acts.

I have read the above release and waiver of liability and fully understand its contents.I voluntarily agree to the terms and conditions stated above under my own free will.

PRINT NAME______________________________

Signature___________________________ Date _______________________________