Yoga Class Registration
Please provide your contact information and sign the waiver form. Once there is a opening in the class, will contact you.
Email *
Name *
Provide your full name (First Last). E.g. John Doe
Gender *
Phone Number *
In XXX-XXX-XXXX format. E.g. 123-456-7890
Have you done Yoga before? *
Health Concerns *
Please describe any health challenges/challenges you are facing. Please select only if applicable.
Other health complaints
For example, if you have any physical condition or pain that may need special attention.
Wellness Group Yoga Schedule *
Required
Personal Therapy Yoga  *
Family Personal Yoga (Parents + Kids) *
Group Picture Permission *
Class Rules
   1.  Classes are subject to change of instructor, format, time or cancellation. Classes with fewer than 5 participants will be cancelled.
   2.  A registration and mandatory liability waiver is required before starting in any class.
   3.  Classes begin promptly on time. If you are late to the class, please be very quiet and not disturb others.
   4.  Please wear comfortable clothing and bring a Yoga mat.
   5.  Please notify instructor of any injuries or medical conditions that you may be experiencing.
   6.  Please let me know if you are not able to join the class.
   7.  Please notify a month before you want to discontinue the class.
Liability Waiver
         1.      In consideration of being allowed to participate in the activities of yoga and associated exercises (asanas) conducted by Minakshi Rai, I do hereby waive, release, and forever discharge Minakshi Rai, volunteers, representatives from any and all responsibilities or liability from injuries or damages resulting from my participation. I also do hereby waive, release, and forever discharge the premises (where yoga is conducted), its trustees, and employees, representatives from any and all responsibilities or liability from injuries or damages resulting from my participation in any activities or my use of the facilities.

         2.      I understand and am aware that strength, flexibility, yoga, and other exercises are a potentially hazardous activity. I also understand that yoga and fitness activities involve a risk of injury and even death, and that I am voluntarily participating in these activities with knowledge of risks and dangers involved. I hereby agree to expressly assume and accept any and all risks of injury or death. This waiver is also binding on all my heirs, executors, and others acting on my behalf.

         3.      I do hereby further declare myself to be suffering from no condition, impairment, disease, infirmity, or other illness that would prevent my participation in this yoga programs. I understand that it is my responsibility to consult with my physician prior to initiating any yoga program. I also understand it is my responsibility to consult with my physician about all health-related changes that may result from the yoga program. I acknowledge that I have either had a physical examination and been given permission by the physician to participate or that I have decided to participate in activities and use equipment without the approval of any physician and do hereby assume all responsibility for my participation in the activities.

         4.     I understand it is my responsibility to notify my instructor(s) of all-physical conditions, injuries, and illnesses.
I agree to the above liability waiver: *
A copy of your responses will be emailed to the address you provided.
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