Community Events with Supinda Siri

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Your safety and well-being is important, and we hope to provide community events that meet the specific needs of each participant to the extent possible. We hold ourselves to the highest professional standards and hope to meet or exceed your expectations with mutual respect for your current state of physical, mental, emotional, spiritual and privacy needs. Check out my current teaching and event schedule at sowingseedsbirthandbody.com

Name *

Contact Info (Email or Phone Number) *

Date of Community Event *

YYYY

I am donating the following amount towards the yoga class. Please make your payment via Venmo @DoulaSupinda or PayPal.me/doulasupinda. Cash and Zelle also accepted. No one is turned away because a lack of funds. Thank you for your donation! *

By submitting this form, I agree to the following: *

I feel well enough to participate in events that may include mindful movement or have medical clearance from my health care provider.

I understand that mindful movement is not a substitute for medical treatment or advice from a medical health care provider.

I understand that it is my responsibility to communicate any recent injuries, surgery and/or discomfort I may feel, so modifications may be offered accordingly.

I understand the risks associated with participating in mindful movement, including, but not limited to short-term muscle soreness and exacerbation of undiscovered injury. I therefore release Supinda Sirihekaphong from all liability concerning any injuries that may occur during the yoga sessions.

Required

In case of an emergency, please contact: *

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