Yoga Student Health Questionnaire

Please read the following statement carefully:

By signing, I affirm that all the information given above is true and I haven’t concealed any serious health problems or disabilities, that could be affected by my yoga practice. I also affirm that a licensed physician has verified my good health and physical condition to participate in this practice.

I understand that during yoga practice, as is the case with any physical activity, the risk of injury is always present and cannot be entirely eliminated. Awareness is fundamental to the practice of yoga. It is my responsibility as a student to monitor each activity and determine whether it is appropriate for me to participate. If I experience any pain and discomfort, I will listen to my body, discontinue the activity and inform my instructors.

I assume full responsibility for any and all damages, which may incur during or after practice.

Kristina Karitinou-Ireland and her assistants take no responsibility for any injury or physical damage may incur during or after practice as well as for any random circumstance.

I acknowledge that I have read this form in its entirety and fully understand and agree to the above terms.

Yoga Student Health Questionnaire and Consent Form

Please complete all the information clearly. All the information provided will be kept strictly confidential.

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