Yoga class registration form: please complete, print and bring to your first class.
Name
Email
Address
Phone
Occupation
Yoga experience
Other sports, activities
List pre-existing or current medical conditions, injuries and/or surgeries
Please answer if pregnant
Due date
Currently how many weeks
Your date of birth
Who is your doctor?
Has Dr. OK'd yoga for you?
Where will you deliver?
YOGA RELEASE AND WAIVER (1) I recognize that yoga may require some physical exertion, which may be strenuous and may cause physical injury, and I am fully aware of the risks and hazards involved.
(2) I understand that it is my responsibility to consult with a physician prior to and regarding my participation in the yoga class. I represent and warrant that I am physically fit and I have no medical condition that would prevent my full participation in the yoga class.
(3) In consideration of being permitted to participate in the yoga class, I agree to assume full responsibility for any risks, injuries or damages, known or unknown, which I might incur as a result of participating in the program.
(4) In further consideration of being permitted to participate in the yoga class, I knowingly, voluntarily and expressly waive any claim I may have against Purple Yoga Hawaii and its instructors for any injury or damages that I may sustain as a result of participating in the program.
(5) I, my heirs or legal representatives forever release, waive, discharge and covenant negligence or other acts.
(6) I have read the above release and waiver of liability and fully understand its contents. I voluntarily agree to the terms and conditions stated above.
I accept the release and waiver (after printing please sign and date the form)
Purple Yoga Hawaii is not responsible for lost or stolen items. All rates are non-refundable and non-transferable.
Yoga class registration form: please complete, print and bring to your first class. 
Print this page