Private Yoga Booking Form & Health Declaration

Please complete the following form in order for me to better understand your needs for our Private Yoga lessons.  This will enable me to create unique lessons, that are safe and fully beneficial to you.

Name *
Name
Do you have any of the following health conditions? *
I have read & agree to the following Terms & Conditions

By Submitting this form you agree to the following Terms & Conditions:

Private Lessons are charged at £185 for 3 x 1 hour sessions (to be used within 4 weeks), £350 for 6 x 1 hour sessions (to be used within 7 weeks). These packages are non-refundable. Payment is required in advance, via online transfer to the following account: Emma Kelly, HSBC, 40-22-26, 01897640

Lessons are to be scheduled in advance at a mutually agreeable time.  More than one lesson a week is possible if the teachers schedule allows.  Lessons cancelled by the client with less than 24 hours notice, will be charge at the full rate.  If the teacher needs to cancel a lesson within 24 hours, then the lesson will be rearranged at a mutually convenient time.   Lessons will take place in your home unless previously agreed otherwise, and will start and end at the agreed time.  The teacher will arrive 5 minutes beforehand to set up as required.  The client will endeavour to provide a suitable safe space and avoid interruptions (phone calls/visitors etc).  Payment to Emma Deery signifies your agreement to the above Terms & Conditions.

Voluntary Participation

Before participating in this or any other exercise program, individuals should consult with a physician. I, the undersigned, acknowledge that I have voluntarily chosen and requested to participate in the yoga class, workshop, event, or activity.

Acknowledgment

I am aware that participation in the yoga class, workshop, event, or activity may be hazardous. I acknowledge that a certain minimum level of physical health, strength, fitness, and flexibility will be required. I represent that I possess the level of health, strength, fitness, and flexibility necessary to participate in these activities. I am voluntarily participating in these activities with knowledge of the risks of injury. I assume all responsibility and liability for any and all injuries I may sustain due to my participation in these activities.

Release 

In consideration for being permitted to participate in the yoga class, workshop, event, or activity, I agree that I, my heirs, assignees, guardians, and legal representatives will not make any claim against, sue, or attach the property of, any of the hosts, instructors, organisers, or participants in the yoga class, workshop, event, or activity including but not limited to Emma Deery, for injury or damage resulting from my participation in such yoga class, workshop, event, or activity. I release all such hosts, instructors, organisers, and participants, their agents and heirs, from any and all actions, causes of action, lawsuits, claims, or demands that I, my assignees, heirs, guardians, and legal representatives now have or hereafter may have for any and all injury, illness, loss of or damage to property associated with my participation in the yoga class, workshop, event, or activity. 

I have carefully read this agreement and fully understand its contents. I am aware and agree that it is a complete release of liability for any injuries or damages I may sustain due to yoga classes, workshops, events, and activities with Emma Deery.  I will inform Emma Deery of any medical changes.