New Member Registration

Registration

Contact and Personal Information

Gender

Male

Female

Medical History

Do you suffer or have you ever suffered from any of the following conditions?

Head and Neck

Migraines

Dizzy Spells

Vision Problems

Neck Pains

Respiratory

Shortness of Breath

Asthma

Are you pregnant?

Yes

No

I wish to participate in yoga classes (hereinafter called “this activity”) maintained and controlled by DemiYoga Fitness. I hereby declare that I am physically capable of participating in this activity and I have not suffered any injury, loss or damage which affects my ability to enrol and participate in yoga fitness classes. Nor have I been advised by any medical practitioner or professional wheresoever and whatsoever of any health related reasons which will cause or will likely cause me any injury, damage or loss.In the event that I have damaged any property belonging to DemiYoga Fitness, I agree to indemnify DemiYoga Fitness in full for all damages incurred. I acknowledge that I have read this waiver of liability carefully and I understand its meaning and I am voluntarily releasing DemiYoga Fitness from all liabilities arising out of my participation in this activity * *

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Registration

Contact and Personal Information

Medical History

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