Health Questionnaire and Liability Waiver To be able to join the Yoga classes please fill out this Registration form and read the Liability Waiver below.With any question please don’t hesitate to email us. For Retreats organised by Melinda Szepesi Yoga please scroll down. Name * First Name Last Name Email * Would you like to be added to our newsletter(monthly with free resources/on demand classes, news and offers) * Yes, please No thank you Emergency Contact * Name, relation, and phone number of your Emergency contact Any Medical conditions, ailments, allergies, injuries? OR Have you had any surgery in the past year? OR Are you /could you be, pregnant, or have you given birth in the last six weeks? * Or do you have any old injuries that still trouble you? Or any medical conditions that might be adversely affected by yoga practice? How long have you been practicing? Any other comments you would like to make: You may request anything and we will try to accommodate, or anything else you'd like us to know about, please write it below. Disclaimer * I take full responsibility for my voluntary participation to work at my own capacity. I release the instructor from liability resulting from any injury or discomfort from my attendance and participation. Please be aware that your yoga teacher cannot give any modifications or alternatives that may be appropriate, for conditions that have not been declared. Melinda Szepesi Yoga isn't qualified to express an opinion that you are fit to safely participate in any yoga sessions, for that You must obtain professional or specialist advice from your doctor before participating if you are in any doubt. COVID-19 precautions: In the interest of keeping everyone safe, please inform us immediately and do not attend the classes if you are suffering from any recognised Covid-19 symptoms. The information you supply will only be used for the purpose of health and safety and to contact you regarding classes held by Melinda Szepesi Yoga. You won't be sent a newsletter unless you opted in. The Undersigned agrees that you have read, understand, and agree that all the Registration information provided is correct to the best of your knowledge: Thank you for filling out the form. We cannot wait to meet you. If you have any further requests please don’t hesitate to email us at info@melindasyoga.com Cornwall Yoga and Mindfulness Retreat // October 2023 Greece Yoga Retreat Waitlist // June 2023 Norfolk City Escape(Yoga Retreat) // March 2023