Aerial Yoga Health & Registration Form

Please only complete this form if you have had a class or workshop booking confirmed by email. Bookings taken at angela@cloud9yoga.com.

 If you answer yes to any of the following questions we will be asking you for further information to ensure that Aerial Yoga is safe for you and we may request that you consult with your doctor before you take a class. Your doctor should be able to advise you as to the suitability of any exercise. The answers that you give below do not in anyway substitute a medical examination. If in doubt please contact your doctor before exercise.

How did you hear about Cloud 9 Yoga?

Have you ever been diagnosed with a heart condition?

Do you suffer from Glaucoma?

Do you have any pain in your chest at rest or during physical exercise?

Do you have any pain in your chest at rest or during physical exercise?

Do you suffer from epilepsy?

Have you ever been recommended only medically supervised exercise?

Do you suffer with high blood pressure, hypotension?

Do you suffer with low blood pressure, hypotension?

Do you suffer with any joint problems, which maybe made worse with exercise?

Do you suffer with any balance problems, fainting or dizziness?

Have you recently been admitted to hospital or had any surgery in the past 2 years which may affect your ability to participate in Aerial Yoga?

Are you pregnant or have given birth in the last 6 months?

We'd like to contact you by email with our monthly news on our Yoga classes and events, would you like to receive these?

Declaration: I have read and fully understand this form and I confirm that, to the best of my knowledge, the answers given by me are correct and accurate. I know no reason why I should not participate in any form of physical exercise or any activity by an employee or representative of Cloud 9 Yoga. I acknowledge that any suggestion from any such employee or representative regarding exercise, healthcare and nutrition are neither diagnostic nor prescriptive. I agree to notify Cloud 9 Yoga of any future change to the above answers before continuing to exercise. Cloud 9 Yoga may use the information provided by me in this form together with any other information that I may provide to ascertain whether physical exercise is appropriate for me and if necessary to seek further information from my doctor or other specialist. By signing this form I agree to the use of my information as stated in the form and Cloud 9 Yoga Privacy Policy. During an aerial yoga class you are using your own body weight. By signing this form you agree to take full responsibility for your own safety during the class. Please listen carefully to teachers instructions at all times. Cancellation period is 48hrs, cancellations made within the time period are still chargeable.

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