Declaration of health

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Full name *

Do you smoke? *

Yes

Acohol? *

Yes

Have you ever had any surgery? *

Yes

Which one?

Do you use any medication? *

Yes

For what?

Any particular pain/limitation? *

Do you drink water regularly? *

Yes

Are you prengnant, have you had high or low blood pressure, had a cardiovascular problem, or are you having a fever? *

Any allergies? *

Emergency contact *

Note: *

I declare that I am aware of the risks involved in practicing Yoga and experiences that are an integral part of the course, and that I am in perfect health conditions (physical and mental). Any damages they may cause me are entirely my responsibility. I am aware that the IYogaYou School, its directors, as well as its professors and invited professionals, are exempt of any responsibility. *

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms