Registration Form | Georgina Yoga

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georgina@georginayoga.co.uk

07787 227862

New Student Registration Form

First Name

Email Address

Occupation

Last Name

Phone

Are you pregnant?

Have you done Yoga before, if so, what style and how long for?

Do you have any health concerns, aches, pains or injuries I should be aware of?

How did you hear about class?

Disclaimer: I agree that any information, instruction or advice obtained from Georgina Yoga or her associate teachers may NOT be used as a substitute for my doctor's advice or treatment and will be used at my own risk. Check the box to confirm your understanding.

Thanks for submitting!

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