Aligned Embodiment Registration Form

Aligned Embodiment (Yoga Questionnaire + Waiver)

Thanks for your interest in the Yoga & Aligned Embodiment Classes and Workshops. This form helps me plan the best embodiment experiences possible. Please read carefully, sign, and secure your spot for the next one!
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Which session are you attending?

[ Atlanta ] No More Tickets[ Augusta ] September 27th 12pm - 2pm
1. Do you currently practice yoga?*

Yes, dailyYes, as much as I canYes, but not as much as I'd likeNo, but I would like toNo, i'm not interested
2. Which areas are most important to you when you think of yoga?

Physical health benefitsMental health benefitsEmotional health benefitsSpiritual benefitsMeditation and RelaxationStrength & FlexibilityInjury Recovery
3. What style of yoga do you enjoy?

Hatha/BeginnersYinKundaliniRestorativeIts my first time/I'm not sure yet
4. What time would you most likely attend a yoga class (In-person or Virtual)?

Between 6am - 8amBetween 9am-11amBetween 12pm-2pmBetween 3pm-5pmBetween 6pm-8pmOther
5. How long would you like to practice yoga?

30 minutes45 minutes60 minutes
6. What is your age range?

18-2425-3435-4545+
What city do you live in?
WAIVER

Yoga is not a substitute for medical attention, examination, diagnosis, or treatment.

I will make the instructor aware of any medical conditions or physical limitations before class. If I am pregnant, become pregnant or I am post-natal or post-surgical, my signature verifies that I have my physician's approval to participate. I also affirm that I, alone, am responsible to decide whether to practice yoga and participation is at my own risk.

I have read and fully understand and agree to the above terms of this agreement. I am signing this agreement voluntarily and recognize that my signature serves as complete and unconditional release of all liability to the greatest extent allowed by law in South Carolina/Georgia.

Please practice mindfully,

Fenixx In Flow Yoga.
Signature

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Aligned Embodiment Ticket$25.00

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Aligned Embodiment (Yoga Questionnaire + Waiver)