Mums & Bubs Yoga Intake Form & Waiver Name * First Name Last Name Email * Phone * What is your Babies Name * First Name Last Name How old is your baby? Emergency Contact Name * First Name Last Name Emergency Contact Phone * Have you had your 6 week, postnatal check up? Have you been given the all clear to start exercising again by your health care professional? Yes No Please let us know about any injuries or conditions you have: What are you hoping to get out of these classes? What to bring? * I understand that this is an outdoor class (it might be sunny/windy). I will ensure to bring appropriate clothing, sunscreen, hat etc. for my baby as well as a blanket and toys. Please BYO mat. Yes. I have my own mat. Yes. I don't have a mat, please provide one. Acknowledgement of Waiver. Please sign by typing your name. * I agree to receive newsletters and information about upcoming events, classes, workshops and retreats with Yoga with Kerst and hereby certify that the above information is true and complete. I acknowledge that I am responsible for my health and safety as well as my babys/childs health and safety while taking classes with Yoga with Kerst/Yoga on the Deck. I will take responsibility for not exceeding my limits and will report any injury or discomfort to the teacher. I agree to relay any information given to me from my health professionals relating to my health and provide medical clearance where needed or requested. I hereby waive any claim that I (or my baby/child) might have in relation to any injury resulting from my participation in classes. I have carefully read the above waiver, understand the content and agree to comply. Thank you!I look forward to seeing you and your bub on the mat!
