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1. Enter your details   2. Payment  arrow  3. Confirmation

To book please complete the registration form below.
If you have any questions email us.

First name *
Surname *
Address *
Suburb *
State *
Postcode *
Phone number *
Email *
What whould you like to achieve from this program?

What are your 3 (top secret) goals you would like to work towards... or perhaps vices you'd like to leave behind?
Any previous yoga experience? Done the hard yards on the mat or just a newbie?
Any injuries, surgery or conditions we need to know about (including tendency to breathlessness or asthma, back problems, blood pressure, depression and pregnancy)?
Yoga Gear
Where did you hear about the YogaSam Program/Classes?
I agree to the terms and conditions below (please read then check this box).

Terms and Conditions

Any form of exercise can be potentially hazardous. By agreeing to this acknowledgement I recognise the dangers of exercising when injured or impaired, or when carried out without proper supervision. I accept responsibility for your own conduct and actions.

I acknowledge:
• I am over the age of 18 years or have the consent of a parent/guardian
• That yoga is a form of exercise
• I have truly and confidentially disclosed to my teacher:
- Any condition which might affect my ability to participate in a class
- Of the type of medication I am taking, if any
• If there is a change in my ability to exercise without pain or the possibility of causing injury I will notify my teacher immediately

I undertake to notify my teacher if any of the following things occur:
• I am under the influence of alcohol or any drug
(Please note: Students under the influence of alcohol or drugs will NOT be permitted into class under any circumstances)
• I am injured or feeling unwell
• I am menstruating
• I have changed my medication since previously notifying my teacher
• I experience any pain on exertion or during an exercise
• I am receiving treatment from another professional (medical or paramedic included)

I agree to follow instructions from my teacher at all times.
I agree to carry out an exercise routine only as set out by and as supervised by my teacher.

Cancellation Policy
Once my class is confirmed I agree and understand there are no refunds or credits given under any circumstances. My place in the class is not transferable under any circumstances.