New Student Form + Waiver Name * First Name Last Name Preferred pronouns * Third-person personal pronouns (like she/her, he/him, or they/them) you use to refer to yourself Date of Birth * Email * Contact Phone Number * (###) ### #### Preferred Method of Communication Text Message Phone Call Email Emergency Contact Name, Relationship to you, and Phone Number * Any health conditions or major injuries that I need to know about * Have you practised yoga before? * This helps me understand if you are already familiar with yoga or completely new! I'm new or have not practised regularly 1-2 classes per week 3+ classes per week What would you like to receive from your yoga practice? * How did you hear about these classes? * Client Waiver * As far as I am aware, I have disclosed all information regarding my health relevant to the practice of yoga. I take full responsibility for all applications of yoga I practice in the class and outside the class. I understand that the recommendations, ideas or techniques expressed and described in these yoga classes cannot be regarded as a substitute for the advice of qualified medical practitioners. Any uses or applications of recommendations, ideas and techniques, and my involvement in classes are at my sole discretion and risk. It is my responsibility to inform Chloe Jourdain of any changes to my physical or mental health, to listen to my own body when practising yoga in class or at home, and to adjust or stop a posture if experiencing discomfort or pain. I understand that any physical movement may carry a risk of injury to myself, including permanent paralysis or death. I voluntarily and knowingly recognise, accept and assume this risk and warrant that I am physically fit and able to perform activities without risking injury or death. I acknowledge that Chloe Jourdain shall be not be nor deemed to be responsible or liable for any injury, illness or other mishap I sustain arising from or out of, directly or indirectly, the yoga activities. I release Chloe Jourdain from any liability for injuries sustained from yoga during or outside class. I indemnify Chloe Jourdain from all actions, suits, causes of actions, proceedings, claims, costs and expenses which may be taken or made against Chloe Jourdain in connection with or arising out of such injury, illness or mishap to me. I confirm I have read and agree to the client waiver Privacy Policy * I have read Chloe Jourdain's Privacy Policy (see website) and consent to the collection and storage of personal and sensitive information Terms and Conditions * I have read Chloe Jourdain's Terms and Conditions (see website) and agree to abide by them Mailing List I would like to receive emails and updates from time to time from Chloe Jourdain Yes please! No thank you! Thank you!