| If you: | Avoid: |
| 1. Have High Blood Pressure (Hypertension) or Heart conditions or Eye problems like glaucoma or Detached retina |
|
| 2. Have Low Blood Pressure |
|
| 3. Are Pregnant or Menstruating |
|
| 4. Have a back problem |
|
| 5. Have Hiatus Hernia |
|
| 6. Have a knee injury |
|
| 7. Have varicose veins |
|
| Signature: | Date: |
| Name: | Telephone: |
| Address: | Email: |
| Any Health Limitations that may affect your yoga that you wish to share (in confidence): | |
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(Note: Not required if you have signed up on-line, accepting
this declaration - you do not need to send or bring it to me). I wish to
join a yoga class provided by DonsYoga.co.uk D. Declaration - to hand to your yoga teacher for your first enrolment
Signature:
Date:
Name:
Telephone:
Address:
Email:
Any Health Limitations that may affect your yoga that you wish to share (in confidence):