Name *

First Name

Last Name

Phone

(###)

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday

MM

DD

YYYY

Name *

First Name

Last Name

Phone *

(###)

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Are you currently undergoing any fertility treatments?

Yes

No

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 *