PRIVATE CLASSES - New Student Form

Your Full Name:

Address:

City:

State:

Post/Zip Code:

Email Address:

Tel Number:

Do you have any injuries or medical conditions I should know about?

What do you currently aim to achieve through yoga?
lose weightincrease flexibilityrelieve stressovercome injuryother

What outcomes are you expecting from our practice together?

TERMS & CONDITIONS - Please read and initial below.

SIGNATURE
I have read and understand the terms and conditions of private yoga classes as outlined above.

Signed:

Contact: [email protected]
(+1) 310.294.3550