Application for The Wholly Connected Collective Monthly Membership

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Please fill in each question to the best of your ability so that I can best assist you.

Email *

Name *

Today's Date *

YYYY

Do you have any health issues? *

Yes

Please list any healthy issues.
If answered No to above, type N/A *

Are you currently taking any medications?
Please provide details here. *

What are your main reasons for joining The Wholly Connected Collective (for example, release tension, more energy, reducing stress…) and what do you hope to get out of your membership sessions? *

Where are you on your healing / self-care journey? If you are just starting, that is ok! *

Have you done any yoga and/ or meditation before? If so, how long have you practiced for? *

If you have practiced yoga before, are there any styles of yoga you prefer? Is there anything specific you want to include in your session(s)? *

Important Information

In Yoga, remember to never force your body. Be patient and allow progression to happen naturally. Please feel free to stop and rest at any point during the practice and if you experience any difficulties please say. It is also important to note that yoga movements will move energy

( emotion ) through the body, so it can result in emotional moments. This is completely normal and nothing to feel ashamed or embarrassed about.

Refunds

Once a session or package is purchased, sorry NO refunds will be granted except for extreme circumstances. If a drop-in session is purchased and you need to cancel or cannot attend for whatever reason, a credit will be on your account to register for a future session.

By signing your name, you agree to the following:

It is my responsibility to inform the instructor, Heather Linkens of Heather Linkens Yoga, LLC., also referred as HLY,, of any physical limitations before class begins. I represent and warrant that I am in good physical health and do not suffer from any medical condition that would limit my participation in the classes offered with Heather Linkens of Heather Linkens Yoga, LLC. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in any yoga classes, programs, or workshops. I understand the risks associated with the activities offered by Heather Linkens of Heather Linkens Yoga, LLC., and I agree to follow all instructions so that I may safely participate in classes, workshops, or other activities. I hereby WAIVE AND RELEASE Heather Linkens of Heather Linkens Yoga, LLC. its owners, officers, employees, and instructors from any claim, demand, or cause of action of any kind resulting from or related to my participation in the programs offered. In taking part in the yoga classes, workshops, or other activities at Heather Linkens of Heather Linkens Yoga, LLC., I understand and acknowledge that I am fully responsible for any and all risks, injuries, or damages, known or unknown, which might occur as a result of my participation in the classes, workshops, or other activities. I have read the above release and waiver of liability and fully understand its content. I am legally competent to sign and voluntarily agree to the terms and conditions stated above.

Please sign your name below *

Send me a copy of my responses.

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