Registration Form6-week Yoga Series: January 3 - February 12 Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Date of Birth * MM DD YYYY Section Choice of class: Check your option Tuesdays: Essential Yoga Poses Please check your option Drop-in Rate: $20 Series: $108 (Includes all classes + BONUS Meditation Class on Thursdays) Wednesdays: Chair Yoga Drop-in Rate: $20 Series: $108 (Includes all classes + BONUS Meditation Class on Thursdays) Fridays: Beyond Basics Drop-in Rate: $20 Series: $108 (Includes all classes + BONUS Meditation Class on Thursdays) Thursdays: Drop-in Meditation Class Drop-in Rate: $10 Payment Options * I accept Paypal, Vemno and personal check. Please specify your preferred payment method and you will receive pertinent instructions. Paypal Venmo Personal check Terms and Conditions * CYC Yoga Disclaimer, Waiver of Liabilities Important Cautions: At CYC Yoga, we try our best to provide a nurturing and productive Yoga session conducive to relaxation, breathing techniques, and relief of muscular tension. However, not all exercises are suitable for everyone, and our or any exercise program could result in injury. Yoga is not recommended and is not safe under certain medical conditions. Please consult your doctor prior to beginning our activity program, to find out if special restrictions apply. To reduce the risk of injury, never force or strain during exercise. If you experience pain, discomfort, or dizziness during exercise, stop immediately, and consult your doctor. The instructions you receive from Christine Lussier are not suitable for medical diagnosis or treatment. By checking the box, you agree to release, indemnify, defend, and hold harmless Christine Lussier and CYC Yoga from and against any loss, cost, damage, injury, and/or any other claim resulting from or occasioned by your participation in or instructional training provided at yoga classes, health programs or workshops. Christine Lussier assumes no responsibility for injuries suffered while practicing these techniques. Those under 18 years of age must have this form signed by a parent or guardian. Refund Policy: If you chose not to continue with a pre-purchased series, Christine will refund to you the remaining classes or apply this amount to a future series, according to your preference. There will be no refund for classes already taken, or class recordings sent. You must notify Christine by email of your wish to discontinue a series and request a refund before the scheduled date and time of the class. I agree to the terms and conditions outlined above Thank you for registering! You’ll receive further instructions shortly.