Master Yoga Inc 850, Tapscott Rd, Unit 4 Scarborough, ON M1X 1N4

Health Questionnaire

These conditions require specific modifications to your yoga practice. If yes, please give details.
I confirm the above information is correct and that I take responsibility for my own health and safety whilst participating in the yoga class. I also understand that it is my responsibility to:

• check with my doctor if I have any difficulties or concerns about my ability to participate in the yoga class
• advise the yoga tutor of any change in my medical information or ability to participate in the yoga class
• follow the advice given by my doctor and/or yoga tutor
This acts as your digital signature when submitting the form
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