Mum’s & Bub’s Yoga Sign Up & Waiver

Fill out the form below to sign up to our Mum’s & Bub’s/Toddler yoga classes!

Classes run in full term, 10 week blocks with an investment of $150

To join this class you must be 6 weeks postpartum and be signed back to activity from your doctor/midwife.

Our Mums and Bubs class runs on a Thursday 10am – 11am, and our Mums and Toddler’s class runs on a Friday 11am – 12pm at the Arrowtown Community Centre. Please bring your own mat, however if you need one we do have some stored (just let us know prior to class), all props are provided however please feel free to bring your own for comfort.

First Name

Last Name

Phone Number

Bub’s Name

Bub’s Age

Is your baby crawling yet?

No - Mums & Bubs Class Thursday 10am - 11am Yes - Mums & Toddler Class Friday 11am-12pm

Emergency Contact Name

Emergency Contact Phone Number

My doctor/midwife has signed me back to activity.

Yes

Injuries, limitation or any complications during pregnancy or birth the instructor should know about. Has your doctor/midwife recommended any precautions prior to starting this yoga practice?

Message to the team, what date would you like to join the class from?

Waiver

I understand that I will be taking part in a Mums and Bubs yoga class through SoulJuice. I, the name stated above, understand that yoga requires physical movement and body exertion which can result in accident or physical injury. I accept, that any yoga instructor, nor the hosting facility, SoulJuice, is liable for any injury, accident, damage to myself, my baby or my belongings. I undertake the risk and responsibility of personal injury, and I hereby release SoulJuice Yoga and its instructors, from any liability now or in the future. I, the name stated above, understand that yoga cannot be used as a substitute for medical attention, diagnostics or treatment. I should consult a doctor prior to starting this prenatal yoga program. I, the name stated above, recognise that it is my responsibility to inform the instructor of any illness, injuries or pregnancy related complicated before every yoga class. I will not preform any yoga postures that cause pain or strain. I am aware that if a session is missed in my 6 week block I am unable to make this up at a later date. I have enrolled in a program of physical activity. I hereby affirm that I am in good physical condition. My doctor has signed me off to go back to physical activity including this yoga class after giving birth. I understand that yoga is a physical practice that requires strength and flexibility. I give consent for my images and videos to be used on the SoulJuice social media and for advertisement purposes. I hereby affirm that I have read and fully understand the above, I have read and accept the class policies stated above.

Souljuiceyoga@gmail.com | +64 211589796

Mum’s & Bub’s Yoga Sign Up & Waiver

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