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Monday Yoga
Pregnancy Yoga
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Yoga booking

Please select the class you are interested in:

Monday Yoga Pregnancy Yoga

Your contact details

Name:

Date of birth:

Address:

Occupation:

Phone:

Email:

Date you are hoping to commence:

About your pregnancy

Where do you plan to give birth?

Hospital Home

When is your baby due?

Has your pregnancy been normal so far?

Yes No

Why hasn't your pregnancy been normal so far?

Dates of previous births and any miscarriages:

Were there any problems?

Yoga

Have you practiced yoga before?

Yes No

What are you hoping to get out of yoga?

Which aspects are you most interested in?

Physical

Relaxation

Breathing techniques

Meditation

Philosophy

Health

Do you have any existing medical conditions?

Yes No

List your medical conditions:

Are you receiving any medication or other treatments?

Yes No

List your medications or treatments:

Agreement of our terms

Please let me know if you develop any conditions that may require modifying your practice.

Yoga encourages us to take responsibility for our own safety and well being.

I agree that the yoga teacher will not be held responsible for any injury, loss or damage to property or persons.

I have read Suggestions for a safe Yoga practice on the contact page.

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