Your Full Name (required) Your Email (required) Telephone (required) Address/Location of service (required) Emergency Contact Emergency Contact Name (required) Emergency Telephone (required) Relation (mother, brother, friend, etc.) Survey What are your current reasons for seeing a private yoga trainer? Do you have a goal for our time together? Do you have any current or previous health conditions? Please include medical diagnoses, surgeries, accidents, injuries, etc., and approximate dates Please state the areas of discomfort in your body. Try to describe where they are located and type/degree of discomfort. What are your favorite physical movements? Least favorite? Do you have a regular exercise program? Please describe? Release of Liability I understand that yoga includes physical movement, breath-work, meditation, and stretching techniques. As is the case with all physical activity, I understand that the risk of injury, even serious or disabling, is always present and cannot be entirely eliminated. If I experience any pain or discomfort I will listen to my body, adjust or change the posture, and inform and seek assistance from my teacher. I know that yoga is not a substitute for medical attention, examination, diagnosis, or treatment. I also know that all suggestions made by the Yoga Instructor are just suggestions and I am responsible for doing my own research and consulting a doctor before starting any new regimens, including yoga and strength routines. I understand that yoga is not safe under certain medical conditions and take full responsibility for making the informed decision to practice yoga. I hereby agree to irrevocably release and waive any claims that I have now or hereafter may have against Justin Morrison. By checking this box assert I have read and agree to the above terms: Cancellation Policy By checking this box I assert I have read and agree to the 24 hour cancellation policy and understand all cancellations made less than 24 hours in advance will be paid in full: Privacy All communications including the above information, email, phone calls and texts, are strictly confidential and will not be shared with any party, under any circumstance, for any reason. Additional comments for your trainer?