Health & Registration Form

Please complete and submit this health form before you come to your first class. I respect your privacy and will store the information you provide in accordance with GDPR legislation 2018. Your information will be treated in strict confidence and will not be shared with a third party without your permission.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact numbers

Landline or mobile number. do not leave any space in the number.

Email address

Emergency contact details

Name and phone number of a local person. Your relationship with this person.

Health

Yoga can be practised safely by most people. However, there are certain conditions which require special consideration in class. Please list health conditions or disorders (neck, shoulders, spine, hips, knees, ankles, heart, blood pressure, back, abdominal, balance, dizziness, asthma/respiration, diabetes, epilepsy, depression). Please also advise if you are pregnant, have given birth in last 6 months or are trying to conceive.

Occupation

Please state whether you sit, stand, drive and/or use computers for long periods.

Experience of yoga

Have you done yoga before? If so, for how long and what style? And what are your aims in coming to class?

Other sports, hobbies and interests

How did you hear about Red Hat Yoga?

Declaration

I understand that there is some risk associated with all forms of movement and exercise. I agree that I take part in the yoga class at my own discretion.

Yes

No

“Try not to resist the changes that come your way. Instead let life live through you. And do not worry that your life is turning upside down. How do you know that the side you are used to is better than the one to come?”

— Rumi

Health & Registration Form

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