Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday

MM

DD

YYYY

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

By my clicking I agree below, I certify that I am physically able to practice yoga and do hereby agree that Veronica Perretti is not responsible or liable to me for any injury, accident or loss of personal property. I do hereby release Veronica Perretti from any claim or cause of action which may have occurred as a result of any medical problem known or unknown which I have knowledge presently or in the future. I agree to follow the instructional guidelines presented by Veronica Perretti. I certify that I have read this agreement and agree to the terms herein.

I agree

By clicking I agree below, I acknowledge that I know I will be recorded on Zoom. If I do not want to be recorded I will turn off my camera. I understand recordings will only be accessed by members of Online Yoga Club through the private membership site.

I agree