Postnatal Yoga New Student Form

Thanks for your interest in private postnatal yoga classes. Please take a few moments and fill out the form below then click the โ€œSubmitโ€ button at the bottom and I will contact you (usually within 24 hours) with the next steps. Everything communicated between us is kept completely confidential, whether we end up working together or not. 

Yoga is a physical exercise. If you have any serious medical conditions, please check with your healthcare provider before participating. It is your responsibility to inform Jennifer Sbrocchi of any limitations or new conditions you may have before each class. By clicking the "Submit" button you acknowledge that you have answered the below questions, fully and truthfully, to the best of your knowledge, regarding your health and medical conditions. 

Name *
Name
Phone *
Phone
Address *
Address
Emergency contact *
Emergency contact
Emergency contact's phone *
Emergency contact's phone
Baby's birthday *
Baby's birthday
Please mark all that currently apply:
Have you practiced yoga before? *