Yoga for Pregnancy & Birth with Sophie (Saturday 10h15-11h45 @ Shanti Home) September-December 2022

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Please fill in this form to attend Sophie's Prenatal Yoga Classes on Saturdays 10h15-11h45 @Shanti Home (Rue Darwin 8, Brussels 1190)(Place Brugmann area/Ma Campagne).

(Please note that on Saturday 1 Oct+ 12 Nov+ 17th Dec the regular class is replaced by a special session/ Prenatal Yoga & Labour Movements with an exercise ball- You need to sign up separately for those by contacting Sophie (info@sophieyoga.net)

Fees are 60€ for a series of 4 consecutive classes (your place is guaranteed for 4 sessions)

Your place will be confirmed with the payment of the fees within 72 hours of signing-up to:

BE54 1030 6931 9197 - BIC NICA BE BB Sophie Girard-Sequeira)

Mats, cushions etc, can be borrowed from the studio, but please please bring your own if you have one.

Please refrain from coming to the studio if you have flu-like symptoms (and let Sophie know).

CANCELLATION POLICY: unless medical emergency, a minimum of 24h notice is required or the class will need to be charged. You can recover a maximum of 1 class per series.Thanks for your understanding!

Any questions: do contact me! www.sophieyoga.net info@sophieyoga.net +32 499 41 41 91

*All the details in this form remain strictly confidential*

Email *

Your first name: *

Surname: *

What is the approximate due date for the birth of your baby(ies)? *

YYYY

Phone number *

So sorry the classes are fully booked until early December 2022.

Would you like to be informed in case a space becomes available for some or all of the dates ?

Yes please for the Oct-Nov series (Sat 8 Oct+ 15 Oct+22 Oct+5 Nov)

Yes please for the Nov-Dec series (Sat 19 Nov+ 26 Nov+ 3 Dec+ 10 Dec)

Please let me know of any relevant medical issues or previous injuries such as low blood pressure, pelvic pain, back pain, early contractions, etc.,

I have no medical contra-indications to join the classes and I agree to let Sophie know should anything regarding my health changes. I certify that I am at least 14 weeks pregnant at the time of attending my first class. *

Yes

Required

Anything you'd like to add? (if you need a more immediate answer to any questions or comments, please email me directly info@sophieyoga.net)

Send me a copy of my responses.

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