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SOUL PEACE YOGA.FITNESS
 

WELCOME to Soul Peace Yoga. FITNESS!

I am so excited to meet you to discuss your Health & Fitness.

Please fill out the following forms in order to participate. Thank you for your interest and time!

Have you been hospitalized in the last 12 months?
Are you suffering from a medical condition, illness, or injury?

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  EMERGENCY CONTACT
 

YOUR OWN DETAILS:

YOUR EMERGENCY CONTACT DETAILS:

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We’ll contact this person only in case of emergency.

          INFORMED CONSENT PHYSICIAN APPROVAL WAIVER
Do you have a doctor’s permission to participate in physical exercise/ Yoga?

By signing this document, I _______________ acknowledge that I have voluntarily chosen to participate in a program of progressive physical exercise that can enhance the musculoskeletal system and cardiorespiratory systems.  

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In signing this document, I acknowledge being informed of the possible strenuous nature of the program and the potential for unusual but physiological results or death.  

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By signing this document, I assume all risks and well-being.  Hold harmless the instructor,

Stacey Griffiths, Soul Peace Yoga,

Soul Peace Yoga. FITNESS or any person involved with the program offered or testing procedures. The instructor will not be liable.

 

I also understand that I am waiving the PHYSICIAN APPROVAL FORM and if I have any special condition the Prescription from my Doctor with recommendations is provided and that my health is capable of the program presented.  

 

Warm -up, Cool-down and pre /post workout flexibility is also to be performed to prevent injury and cumulative dysfunction.  I also understand the use Essential Oils for Yoga Practice are used at my own discretion.

 

My Fitness Program / Yoga is also to include my responsibility of proper Hydration, Nutrition and Rest because all factors can affect my Health, Performance and Fitness Results. 

Thanks for submitting!

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