fertility yoga ✺ fertility yoga ✺ fertility yoga ✺ Book a private Fertility Yoga session Would you like to book in-person or online? In person Online Perferred date & time Let me know what works best for you. I will follow up to confirm and arrange our session. (Feel free to leave blank.) Date MM DD YYYY Time Hour Minute Second AM PM Your information Name * First Name Last Name Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Birthday MM DD YYYY Emergency Contact Name * First Name Last Name Phone * (###) ### #### Other Information Any injuries or medical conditions? (specify) Are you currently undergoing any fertility treatments? Yes No If yes, please list the treatments: Please select your yoga experience level Beginner Intermediate Advanced Yoga Teacher Liability Waiver & Disclaimer: * I understand that fertility yoga is a holistic practice intended to support overall wellness, reduce stress and promote balance in the body. However, I acknowledge that there is no guarantee that participating in this class will result in a positive pregnancy or affect fertility outcomes. I understand that yoga and physical activities inherently involve some risk of injury. By participating in this fertility yoga class, I waive and release the instructor Annette Rotz and the studio from any and all liability for injuries or accidents that may occur during or after the class. I agree to take full responsibility for my body and actions during the practice.* I agree with the above terms * Thank you for your enquiry, I aim to respond within 24 hours.Annette x