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WellBodyMind Yoga Registration

Please complete this form before attending class. This includes your intake information and liability waiver acknowledgment.

Participant Information
Health & Intake Questionnaire
1. Do you have any current injuries or physical limitations?
2. Do you have any chronic conditions (e.g., heart condition, high blood pressure, joint issues)?
3. Are you currently pregnant?
4. Are you taking any medications that may affect your physical activity?
Acknowledgment & Waiver

I understand that participation in yoga and wellness activities includes physical movement and exertion. I acknowledge that these activities carry inherent risks, including but not limited to muscle strain, injury, or other physical harm. I affirm that I am voluntarily participating in these activities and that I am in sufficient physical condition to do so.

I agree to:

  • Listen to my body and practice within my own limits
  • Modify or stop any movement that causes pain or discomfort
  • Inform the instructor of any changes in my health

I hereby release and discharge WellBodyMind Yoga, its instructor(s), and the Dryden Community Center from any and all liability, claims, or demands arising from participation in classes, including injury, loss, or damages. I understand that instruction is not a substitute for medical advice, diagnosis, or treatment.

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