PHILOSOPHY & YIN WORKSHOP</p>

Name

First Name

Last Name

Address

Email Address

Phone Number

Emergency Contact

Emergency Contact Name

Please describe your experience in yoga (E.g. Amount of years practiced, level, styles)

Please describe any previous/current injuries/surgeries that may affect your physical movement (explain in detail):

Do you have any limitations in movement or practice? Explain

I understand that if for any reason (medical, personal, or otherwise), I am unable to attend this workshop, my payment is non-refundable and non-transferable.

YES

I am in good general overall health and feel physically capable and ready to engage in physical yoga movement. I recognize the possible risks and the chance of injury involved in any physical exercise and hereby take responsibility for determining my own level of participation and take full responsibility for my own health and safety. By signing this form, I agree to not to hold Brynn Rybacek or True FLOW Yoga Inc. responsible for any injuries that may take place during this workshop.

YES

By clicking submit you agree to all of the above statements.

Thank you for completing your Registration Form. Please note that registration is not complete until payment has been made. You can either click below to pay via Paypal’s secure site or you can send $95 to “Brynn-Rybacek-Yniguez” via Venmo. You will be sent a confirmation email once your payment has been received.