YOGA FORM | Keep Me Young

Choose a date required

"YOGA WEDNESDAYS"

First name

Last name

Phone (we will invite you to our members only Whatsapp & Strava group)

Emergency Contact Number

D.O.B

Day

Month

Year

Do you have any health issues or concerns e.g. injuries, illness etc?

Yes

If answered yes, please tell us more below:

Which of the below best describe your current Yoga experience?

Beginner (never or not very often)

Regular (2-3 times a week)

Occasionally (now & again)

Waiver & Release of Liability (Essentials)

By joining the Keep Me Young Run Club, I understand and agree that:

I am voluntarily taking part in runs and activities.
Classes carries risks (injury, illness, falls, weather, traffic, surfaces).
I confirm I am fit to participate.
I release Keep Me Young Ltd and its organisers from liability for injury or loss.
This waiver applies to all future participation.
Photos/videos may be used for promotion (I can opt out by asking).
Under 18s require parent/guardian consent.

By registering, I confirm I have read and agree to this waiver.

Where did you hear about us?

I have read and agree to the Terms and Conditions of Keep Me Young Ltd.

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Payment required

£8.5