Private Yoga Intake & Waiver

First name

Last name

Address

Phone

Date of Birth

Month

Day

Year

PLEASE TELL US ABOUT YOURSELF

Have you practiced yoga before?

Yes, I am an experienced yogi

Yes, but I consider myself a beginner - OR - it has been a long time since I have practiced

No, I am new to yoga

What are you interested in accomplishing through private yoga?

Do you have any acute/current or chronic injuries, physical limitations, or health conditions that limit how you move?

Is there anything else you would like us to know about you related to private yoga sessions?

CONSENT, RELEASE & WAIVER OF LIABILITY

Please take a moment to read the full Consent, Release, & Waiver of Liability by clicking the link below.

https://www.phpyoga.com/waiver-release-of-liability

I acknowledge that I have thoroughly read the CONSENT, RELEASE & WAIVER OF LIABILITY. I further acknowledge that I voluntarily and knowingly agree to the terms and conditions stated therein.

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