Booking form for one-to-one yoga sessions

Name *

First

Last

Date of birth *

Email *

Contact number *

Address

Medical conditions or anything you'd like to mention / any questions?

How did you find out about the class? *

Emegency contact name and number in case need during the session (someone other than you) *

Occasionally I might use photos or videos of the class for my website or social media. Are you happy for me to use photos or videos that include you? *

As far as I am aware, I have disclosed to my yoga teacher all information regarding my health relevant to the practice of yoga. I agree to inform the teacher of any changes to the above information at the beginning of any class. I take full responsibility for all applications of yoga I may practise during yoga classes in person, at a venue, home, via online video class or outside the classes, both now and in the future. I accept that Yoga with Rosanna does not take responsibility for any applications of yoga practices described or shown and in books and videos. I fully understand that the recommendations, ideas and techniques expressed and described in classes, as well as in books and videos cannot be regarded as a substitute for the advice of qualified medical practitioners. Any uses to which the recommendations, ideas and techniques are put are at my sole discretion and risk. I should consult a medical professional before beginning any activity program, including yoga. *

Please tick to accept

For the safety reasons, I will not attend the class if me or anyone in my household has confirmed or suspected covid-19, or if we are experiencing any covid-19 symptoms. I have read the covid safety information page at www.yogawithrosanna.co.uk/yoga-classes-basingstoke-covid-19-safety/ and agree to follow the guidance given. I understand that the classes might be changed from in-person venue held classes to online video classes at any time (with as much notice given as possible), depending on the changing pandemic situation and to ensure the safety of myself and others *

Please tick to agree

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