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Pre activity readiness questionnaire & waiver
Please fill out a form pre activity and again if any changes occur
First Name
Last Name
Email
Date of Birth
Have you been hospitalized in the last 12 months?
No
Yes
Are you suffering from a medical condition, illness, or injury?
No
Yes
If you answered yes to any question, please elaborate
Emergency contact or perantal consent for under 16's, name, number and relationship
I declare that the info I’ve provided is accurate & complete. I consent to any photos/videos of myself to be shared and used. I have recieved consent from my doctor to take part in yogadrum activities and I will inform the teacher of my health conditions at the start of class.
Submit
Thanks for submitting!
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