Register Now!

New Adult Student Intake Form

Please use this form to tell us about your experience with yoga, any health concerns, and your goals for your yoga. The following questions are asked solely for the purpose of assisting you better. All answers will be kept confidential. Please talk with the instructor if you do not feel comfortable answering here.

You will receive confirmation of your registration via email within 48 hours of completing the registration form. Your teacher will contact you a few days before the class starts to confirm the final details.

If you have any questions or need additional information, please contact our program director, Jean McDonald at jean@CreateCalm.org.

Name
Address
Have you practiced yoga before?
Do you have any injuries or physical limitations that will impact your ability to participate in class?

If you checked any of the above conditions, you should consult your healthcare provider before engaging in exercise.

Do you mind if the teacher touches you to make adjustments in yoga poses?
Do you have any specific areas of your body or physical challenges you want to work on? Areas that have a lot of tension or need strengthening, etc.?
Selected Value: 0
I understand that Yoga is a physical discipline that requires a certain amount of mental concentration and physical strength and endurance. As is the case with any physical activity, the risk of injury, even falling, is always present and cannot be entirely eliminated. I agree to work at my own pace and according to my own limitations, including but not limited to listening to my body, adjusting appropriately, and responsively and attentively responding to any pain, discomfort, or injury. Yoga is not a substitute for medical attention, examination, diagnosis or treatment. I affirm that I alone am responsible for deciding whether to practice yoga and I take full responsibility for my safety and well-being.
I hereby irrevocably release and waive any claims that I, my heirs, or representatives have now or hereafter against INA Wellness LLC, Create Calm Inc, and their staff and instructors, and affiliate studios and instructors from any liability associated with my participation in any classes, workshops and/or private or group instruction provided.