Prenatalregform

Name ________________________________________________________________________________
Address_______________________________________________________________________________
City _____________________ Zip _____________
Home#________________________________________________________________________________
Work#_______________________________________________________________________________
E-Mail: _______________________________________________________________________________
Emergency contact: _____________________________________________________________________
Which session will you be attending?________________________________________________________
How did you hear about us? _______________________________________________________________
What are your expectations? ______________________________________________________________
PHYSICAL LIMITATIONS_________________________________________________________________
______________________________________________________________________________________
DO YOU SMOKE? ___________________________
THIS IS A RELEASE. PLEASE READ BEFORE SIGNING AND ASK QUESTIONS IF YOU DO NOT UNDERSTAND
ANY OR ALL OF IT. I hereby stipulate that I am physically sound to proceed with instruction in Yoga. I agree
that all exercises and lessons shall be undertaken at my sole risk and that Yoga West and/or its owner(s),
instructor(s) and/or contract personnel and/or employee(s) shall not be held liable for injuries, losses or
damages to my person or property arising out of, or connected with, the use of services or facilities of Yoga
West or the premises in which the same are located. I do hereby forever release, waive, discharge and
covenant not to sue Yoga West and/or its owner(s), instructor(s)and/or contract personnel and/or employee(s)
from all such causes of action. I agree to listen to my body and practice carefully and without force or strain; to
stop yoga if I feel weak, faint, nauseated, or unduly tired, uncomfortable, or in pain, and advise the instructor of
same. I AM FREE TO ASK QUESTIONS BEFORE, DURING OR AFTER CLASS. If under 18 years old, parent or
guardian must sign: I give permission for my child to participate in Yoga classes, and consent to the above
terms and conditions. I understand my tuition is non-refundable and non-transferable, and will not be applied
toward any future sessions for any reason, and that Yoga West does not prorate, give credits or make-ups.

Signature: ______________________________________

Date: __________________________________________

All parts of the class are equally important. Any missed portion will diminish the expected benefits. If you arrive
late, enter quietly and take time to warm up your muscles before joining the rest of the class in movements. Be
on time and participate fully to reap the full rewards of each class. Wear comfortable exercise attire that allows
you to move, and do not wear shorts you can “see up.” No food or drink (except water), cell phones, perfume,
or noisy jewelry. We assume no responsibility for lost, stolen or damaged articles.

Please mail completed registration to Yoga West at P.O. Box 6305, Katy, TX 77491. Payment must be
made to reserve your space. Please mail payment with registration form, or call 281.579.2287 to pay
with MasterCard or Visa. Thanks.