HEALTH FORM

If you are NEW to Yummy Yoga, please fill in this brief online health form below if you would like us to be aware of any injuries that you may have, or any recent illness or surgery. It is also important that you let us know if you are pregnant- Thank you ;)

For any other queries, email Caroline(Caroline@yummyoga.co.nz) OR
If you like to speak with someone, please call Caroline (021) 451424 during Office Hours (9-5pm).
Thank you ;)

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Health Form

* Indicates required field

Name *

First

Last

Phone Number *

Email *

General Health/Injuries/Surgeries/Anything we need to know to keep you safe? *

What is your motivation for doing yoga? *

Waiver: I acknowledge that participating in physical activity can carry a risk and I accept responsibility for that risk. YES/NO *

Name of an alternative contact person for you please, such as a Parent/Spouse/Friend *

Mobile number for that person *

Where did you hear about Yummy Yoga *

Submit