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Practitioner info: pre-activity questionnaire

Your privacy is sacred. The information you provide below is confidential and will not be shared with anyone outside of Yoga of the Isle.

First, a bit about you ...
Name *
Date of birth *
Date of birth
Now, the general but important things... Your answers help with tailoring teaching to your needs.
If you answered 'Yes' to any of the above, please seek guidance from your GP or appropriate allied health professional prior to undertaking physical activity or exercise. Pre-existing medical conditions do not necessarily preclude your participation; we just want to make sure to provide the best experience that we can.
Emergency contact name *
Emergency contact name
Finally, about the yoga. Not required, but helps with tailoring the classes to what you want to get out of them.
There is no right answer!
Have you practiced it before? If so, what type and how often? Plus any other details you want to share.
Can be physical, mental, emotional, spiritual ...
Would you like to be contacted personally before the first day of class to discuss any questions or concerns? *
By clicking 'submit' you confirm that you believe, to the best of your knowledge, that the information you have supplied within this questionnaire is true and correct, and that you have read and agree to the waiver and release outlined below.
Thanks for joining us!

Waiver and release

By completing and submitting the above form, you're confirming that you have read and agree to the following:

  1. I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension. As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will listen to my body, discontinue the activity, and ask for support from the instructor. I will continue to breathe smoothly. I assume full responsibility for any and all damages, which may incur through participation.
  2. I understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. By signing, I affirm that a licensed physician has verified my good health and physical condition to participate in such a fitness program, if required. In addition, I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate. I also affirm that I alone am responsible to decide whether to practice yoga and participation is at my own risk. I hereby agree to irrevocably release and waive any claims that I have now or may have hereafter against Yoga of the Isle and all related facilities and premises for any personal injury or negligence. Additionally, the facility, instructor and Yoga of the Isle are not in any way responsible for any loss or damage of my personal property.
  3. Those under 18 years of age must have this form completed and signed off by a parent or guardian.
  4. If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.
  5. I have carefully read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am signing this agreement voluntarily and recognise that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law and that it cannot be changed orally.

If at any time during the class, you feel discomfort or strain, gently come out of the posture. You may rest at any time during the class. It is important in yoga that you listen to your body, and respect its limits on any given day. If you have any questions or concerns following a class, please get in touch!