Intrinsic Mind Holistic Health & Wellness
Yoga / Pilates
Welcome to Your 1:1 Yoga / Pilates / PT session Questionnaire
Inversion / Arm balance and Backbends Masterclass workshop
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Videos and Photos are taken on the day and will be used on the Intrinsic mind website and social media page. I am okay with this
Terms of attendance and participation
If at any time during the class, you feel discomfort or strain, gently come out of the posture. You may rest at any
time during the class. It is important in yoga that you listen to your body, and respect its limits on any given day.
I understand that yoga includes physical movements as well as an opportunity for relaxation, stress re-education
and relief of muscular tension. As is the case with any physical activity, 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,
discontinue the activity, and ask for support from the instructor. I will continue to breathe smoothly. I assume full
responsibility for any and all damages, which may incur through participation.
I understand that Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not
recommended and is not safe under certain medical conditions. By signing, I affirm that a licensed physician has verified
my good health and physical condition to participate in such a fitness program, if required. In addition, 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 hereby agree to
irrevocably release and waive any claims that I have now or may have hereafter against Yoga Australia and all related
facilities and premises for any personal injury or negligence. Additionally, the facility, instructor and Yoga Australia are
not in any way responsible for any loss or damage of your personal property.
Those under 18 years of age must have this form signed by a parent or guardian.
If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then
the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions
severed here from.
I have carefully read and fully understand and agree to the above terms of this Liability Waiver 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 and that it cannot be changed orally.
I understand and agree to the above terms
Yes I understand
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0438 520 219
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