RISE Adult Yoga Classes

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First & Last Name: *

Email Address: *

Mailing Address (include town): *

Phone Number: *

Please list any injuries, illnesses or medical conditions that may be relevant: *

Emergency Contact Name: *

Emergency Contact Phone Number: *

I understand yoga is not a substitute for medical attention, examination, diagnosis or treatment. I understand yoga is not recommended and is not safe under certain medical conditions. I understand that I must be aware of my own capabilities as a yoga student at RISE Vineyard Performing Arts. I take full responsibility for knowing my limits and informing the instructor of any limitationsI might have. I hereby waive and release any claim for any injury against HeatherDyas-Fried or RISE Vineyard Performing Arts.

I have read, understand, and agree to the above (please type name) *

Payments are made via cash, check or Venmo. Please contact Heather Dyas-Fried directly to set-up pre-payment or you can bring payment when attending the first class. Please indicate below your class preference. PLEASE NOTE: you can attend one class and still purchase a class card afterwards with the discount. *

Class Card ($90 for all 10 classes... SAVE $10!)

Half Class Card ($45 for any 5 classes)

Single Class ($10 per class)

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