1:1 Container Session Preparation
Thanks for booking a session with me. This form will help both of us prepare for our session together.
Sign in to Google to save your progress. Learn more
Email *
Name *
Have you worked with a coach/mentor before? What are your expectations? *
 What do you specifically want to work on in this session? *
Are you living with a health challenge? What are your key symptoms? *
What is your age group? *
Do you work/volunteer/look after children... *
Could you, briefly, give me a sense of the things you are doing to manage your health and wellbeing *
How did you hear about my coaching services? *
Required
Waiver (a general release like you would see in a studio)
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.

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. 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 MelissaNParkes Consulting LTD.

I have read and fully understand and agree to the above terms of this Liability Waiver Agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law.

Signature. Writing your name below confirms that the information you have provided is correct as you know it. *
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