Refer Friends | Yoga Zen By Jen

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Yoga Zen By Jen

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Yoga Zen By Jen

info@zenbyjen.com

Reno, NV

First name*

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Day

Year

Multi-line address

Country/Region*

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City*

Zip / Postal code*

Any diagnoses, injuries or surgeries you’d like me to be mindful of (include dates if applicable):

What brings you to yoga? What are you hoping to achieve in our sessions together? (pain management, reduce anxiety, increase fertility, achieve certain postures, sleep better etc.)

Any special requests (poses, techniques or meditations) you would like to make sure we explore during your sessions? Are there any postures you would like me to avoid during our sessions together?

Are there any favorite songs of yours that you would like me to add to the class playlist?

I recognize yoga requires physical exertion that may be strenuous and may cause physical injury. I am fully aware of the risks and hazards involved. I understand that it is my responsibility to consult with a physician regarding my participation in yoga. *

I Agree

I understand that if I am pregnant, I will take necessary steps to ensure my doctor and health care providers agree I can safely practice yoga. I agree to assume full responsibility for any risk, injuries or damages, known or unknown, which I might incur *

I Agree

I acknowledge that this is not a substitution for talk therapy and that talk therapy is recommended in addition to any deep healing work.

I Agree

I knowingly, voluntarily and expressly waive any claim against Zen by Jen for injuries or damages I may sustain as a result of practicing yoga. I, my heirs and legal representatives forever release, waive, discharge and covenant not to sue Zen by Jen*

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