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As a new member I accept and agree with the following:

[x_alert heading=”” type=”warning”] I understand that yoga is not a substitute for medical attention, examination, diagnosis or treatment.   I recognise that it is my responsibility to notify my teacher of any serious illness before every yoga class. I will not perform 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 taking of the class.   If the new member is under 18 years of age this form must be digitally signed by a parent or guardian or you must complete and return the paper form signed by a parent/guardian.[/x_alert] To signify agreement the new member (or parent/guardian) should check the “Acceptance” box and enter the correct CAPTCHA code. [/column] [column type=”one-half” last=”true” fade=”false” ]

First name
Family name
Male    Female  
DOB (must enter as YYYY-MM-DD)
Email address

Preferred contact number

Any health issues, injuries or conditions?

Are you pregnant?   Yes     No
If pregnant, how many weeks are you?

Level of yoga experience?

How did you hear about Yoga With Grace?
  Facebook   Website   Word of mouth   Other 
If answer is "Other" to the above please specify

To be completed by new member

 I accept the terms and conditions of membership.

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