Cong Yoga Sign-Up Form

Yoga Sign-Up Form

Thank you for your interest in joining yoga classes at The Crossroads Community Centre, Cong. I would appreciate it if you could complete the sign-up form prior to attending yoga classes.

Payment Options

To secure your place the following payment options are available:

Cash: I would appreciate it if you could place it in an envelope with your name and I will collect it from you before the class

Bank Transfer: IBAN: IE82AIBK93101257495014

Paypal link: https://www.paypal.com/paypalme/eiliswallwellness or eiliswallwellness@gmail.com

Revolut: 085 7254446 or revolut.me/eilisvzz

Where appropriate, please include your name on the payment and if you have any queries, please get in touch.

Thanks very much,

Eilís

Name

First Name

Last Name

Phone

(###)

###

####

Yoga class time

Have you practiced Yoga before?

If so, what kind and for how long?

Please list any injuries, medical issues, and/or important medical history:

I would like to sign up to Eilís Wall Wellness newsletter for future offers, promotions and wellbeing tips

Liability/Student Waiver Agreement

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, adjust the posture and ask for support from the teacher. I will continue to breathe smoothly. Yoga is not a substitute for medical attention, examination, diagnosis or treatment. Yoga is not recommended and is not safe under certain medical conditions. I affirm that I alone am responsible to decide whether to practice yoga. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Eilís Wall Wellness.

Preferred payment method