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First Name 

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Last Name

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Email 

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Password 

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I am currently in good health and physical condition to perform all the exercises and activities for yoga to the best of my ability.  I am physically fit and have no medical condition that would prevent me from participating.  My teacher (Parna) should be aware of the following injuries or disabilities which may affect or limit my participation:

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List injuries or disabilities HERE.

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I have carefully read the entire Yoga Student Waiver and release of liability, I fully understand that I give up substantial rights by signing it, and I do it voluntarily.  I agree to participate in this class knowing the risks and conditions involved and do so entirely of my own free will.

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               I agree with the Yoga Student Waiver & Liability

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Please type your name here to sign Waiver.
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Today's Date (MM/DD/YEAR)

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City of Residence

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