YIN REIKI FORM

**If you have checked any of the boxes in the above question, it is important that you discuss these with your Doctor and get clearance that it is ok for you to participate in the yoga class. These sessions are not a substitute for medical counseling or treatment. Your doctor will be able to decide if there are any medical reasons why you should not take part in Yoga.

Please note photos may be taken during the class for future promotional use. These will be discrete, non-invasive and in most cases group photos. *

I'm ok with photographs I request you ask my permission before use if I am in them I'd prefer not to be in any photos

By checking the box below and submitting this form I agree that I have read and answered the above questions to the best of my knowledge. Where I answered Yes to any question I agree that I have discussed the issue with my Doctor to ensure that it is safe for me to begin. I undertake all exercise programs and classes freely and voluntarily and understand that Management, staff and instructors will not be liable for any personal injury arising through participation. I further undertake to advise the teacher before the commencement of any class if for any reason my ability to exercise has changed. *

I have read and agree with the above statement.

Yoga Form