Name *

Including the name you wish to be addressed as (if different)

First Name

Last Name

I confirm that all information given is accurate and correct at the time of completing this form *

Yes

Name of Emergency Contact *

First Name

Last Name

I understand that yoga includes physical movement, breath-work, meditation, and stretching techniques. As is the case with all physical activity, I understand that the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort I will listen to my body, adjust or change the posture, and inform and seek assistance from my teacher. I know that yoga, and sound practices, are not a substitute for medical attention, examination, diagnosis, or treatment. I also know that all suggestions made by Charlotte Fraser are just suggestions and I am responsible for doing my own research and consulting a doctor before starting a yoga practice or sound session. I understand that yoga and sound sesions are not safe under certain medical conditions and take full responsibility for making the decision to practice yoga and participate in sound sessions. There are no officially recognised side effects of sound healing. However, sometimes complemenary therapy can cause a healing reaction. In the unlikely event that this does happen, and if it needs further attention I will consult a doctor. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Charlotte Fraser. *

Yes I have read, understand and agree to the above statement

Today's Date *

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