Marulamala Students

Student Registration Form

This is a confidential form with your personal information that will help enhance your class experience and help your teacher assess your needs and what is appropriate for you according to your health and fitness.

It is also a legal requirement and a pre requisite to being accepted as a student. All the information on this form will be kept confidential between you the participant and Marulamala Yoga.

Thank you for taking the time to fill out the details correctly. Please also sign where indicated at the end.

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BackNeckLegsArmsShouldersHips
DoctorPhysioChiropractorNaturopathOther
DiabetesAnaphylaxisStrokeHigh/Low Blood PressureVertigoAllergiesAsthmaRespiratory (other)Seizures/EpilepsySleep ProblemsHeart ConditionsEmotional/Mental State (Depression, Anxiety)Digestive SystemOther?

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NOTE: It is your responsibility inform Marulamala Yoga of any medical conditions or physical problems which may restrict your practice. Please always make your teacher aware if you are suffering from any particular physical or emotional problems in order that he/she can take account of this during class.

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Please Note: If you are pregnant or think you may be, it is NOT advisable to participate in a general yoga class in the first trimester of pregnancy. Please request our Yoga and Pregnancy Advice Sheet.
SHOULD YOU HAVE ANY CONCERNS WHETHER OR NOT YOU ARE ABLE TO PARTICIPATE IN A CLASS PLEASE CONSULT YOUR HEALTH PROFESSIONAL PRIOR TO COMMENCEMENT

Release and Indemnity
As is the case with any physical activity, the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. By signing below I acknowledge I understand that in yoga class I will progress at my own pace and if I experience any pain or discomfort, I will listen to my body, adjust the posture and ask for support from the Teacher. I will continue to breathe smoothly and If at any point I feel over exertion or fatigue, I will respect my body’s limitations and I will rest before continuing yoga practice.
Marulamala Yoga cannot be held responsible for ANY personal injury sustained during a class. Please choose a class that best suits your ability. This way your practice will flourish and you will receive the full benefits of yoga.
I therefore fully acknowledge that participation in yoga classes exposes me to a possible risk of personal injury. I am fully aware of this risk and hereby release Marulamala Yoga and its Teachers from any and all liability, negligence or other claims arising from or in any way connected with my participation in yoga class.

Thank you for taking time to fill out this form today. Please check to make sure this information is correct.