Zendeep Registration Form
Thursdays 5.30 - 6.30pm

$15 per class or $120 for a x 10 concession (valid for 6 months)

Please direct credit to my business account:
The Adaptive Yogi
01-1811-0234016-46
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Name: *
E-mail: *
Do you have any injuries and/or disabilities or simply niggles that are challenging for you to take part in a yoga practise? (and please know that they can all be adapted for!) *
Mobile Number (for emergency unforeseen last min class notifications) *
Have you practised yoga before? If so, for how long and what style *
Have you practised pranayama and meditation before? If so, for how long and what style *
Would you like to be added on to my email database to keep up with my classes, specials and events *
Emergency contact name and number please.... *
WAIVER STATEMENT:                                                        I understand that Jennie Jackson, cannot give medical advice and that the information I have given will be used as a guideline to the limitations of my ability for Jennie’s yoga sessions. I understand that 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, adjust or change the posture, and inform and seek assistance. I know that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I also know that all suggestions made by Jennie Jackson are just suggestions and I am responsible for doing my own research and consulting a doctor before starting a yoga practice. I understand that yoga is not safe under certain medical conditions and take full responsibility for making the decision to practice yoga. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Jennie Jackson. *
Thank-you!
Namaste Jen :)
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