Toni Marie Yoga - Mum & Baby Yoga Class

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Wednesday's 12:30PM

Email *

Full Name *

Address *

Contact Number *

Email address *

Date of Birth *

YYYY

Baby's name and gender *

Baby's Date of Birth *

YYYY

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Telephone Number *

Please provide details of any of your Medical Conditions *

Please provide details of any of your Injuries *

Please provide details of any of your regular medication *

Please provide details of anything else that may affect your ability to participate in the Yoga class, particularly any post natal conditions *

Please provide details of your pregnancy and delivery, including any difficulties *

Please provide details of any other children and/or pregnancies *

Please provide details of any medical conditions of your baby that may affect their ability to participate in the Yoga class *

Do you agree to photographs being taken in class that will be used to promote Toni Marie Yoga classes on social media? *

Yes

Please Read the following disclaimer and tick the the box to agree. I take full responsibility for myself and my baby, and for everything that happens to me and my baby in relation to the class. If I have any concerns, I will seek the advice of my medical professional before proceeding with the classes. I will keep the Instructor informed of any health issues that arise over the course of the classes, both for me and my baby. *

I agree

I disagree

Required

Payment

The class fee of £22 for a 4 week block is payable via bank transfer. Your place is only confirmed once payment has cleared.
Bank transfer details are:
Name: Mrs T Aspinall
Sort: 40-31-05
Account: 51501658

Please note that classes are none transferable. The class sizes are limited for Mum & Baby and so if you are unable to attend a class from your block booking, unfortunately this can not be transferred to another block.

All your data is collected, stored and used in compliance with GDPR regulations.

A copy of your responses will be emailed to the address you provided.

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