Registration & Health Screening Form Please complete before attending your first class. I will handle and protect your personal information sensitively in line with Data Protection Act 2018 and General Data Protection Regulation (GDPR). Learn more in my Privacy Policy. Registration & Health Screening Form Name * First Last * Last Email * Phone * Home address including postcode * Age or date of birth (optional) Occupation (optional) Do you have any of the health conditions listed below? Please tick all that apply. * Back or shoulder ache Joint issues Anxiety or depression High blood pressure Low blood pressure Heart conditions Hearing or visual impairment Epilepsy / seizures Pregnancy Gave birth in the last 4 months Had major surgery in the last 12 months NONE OF THE ABOVE Do you have any conditions not listed above that might impact your yoga practice? If yes, please specify. * Would you describe your yoga experience so far as: complete beginner, beginner, intermediate or advanced? * If you have practiced yoga before, what style of yoga was it? * What is your primary goal for taking up yoga? * How did you find out about this course or class? Please tick all that apply. (optional) Blog subscritpion Informed by Sossi Friend or family recommendation Flyer or poster Facebook or Instagram Twitter / X LinkedIn Next door neighbourhood app Google search OTHER By submitting this form: (1) I acknowledge that yoga is not a substitute for a doctor’s advice or medical treatment; (2) I take full responsibility for my health during my yoga practice; (3) I confirm that I have disclosed all information regarding my health as relevant to the practice of yoga and I agree to notify you of any future changes. PLEASE TYPE YOUR FULL NAME BELOW. Thank you. * If you are human, leave this field blank. Submit Please leave this field empty Hello Thanks for being here! Sign up to receive my blogs straight into your inbox. Email Address * You can unsubscribe anytime! But hopefully you'll stick around 😉 Check your inbox or spam folder to confirm your subscription.