Flutterbumps and Flutterbabies booking form

Name *

First

Last

Email *

Contact number

Address

Your date of birth

Are you joining the class a) pregnant or b) postnatal

Pregnancy due date, or postnatal date you gave birth *

Have you any yoga experience? (optional)

Everyone is welcome to the class, including complete yoga beginners

Midwife and surgery name

Please mention anything which you feel may be relevant to your yoga practice eg injuries, conditions, medical information

Emergency contact name and number in case needed during the class (someone other than you) *

If at any time during the class, you feel discomfort or strain, gently stop the movement or come out of the posture and rest. You may rest at any time during the class. It is important in yoga that you listen to your body, and respect its limits on any given day. I understand that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a medical professional or midwife prior to beginning any activity program, including yoga. I recognise that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I will not perform any movements or postures to the extent of strain or pain. I accept that neither the instructor, nor the hosting facility, is liable for any injury, or damages, to person or property, resulting from the taking of the class in person at a venue, home or via online video class *

Please tick to accept

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