About Iyengar yoga
EVENTS & HOLIDAYS
2015-yoga holiday photos
2016-yoga holiday photos
2017-yoga holiday photos
2018-Yoga holiday photos
Tuesday Level 3 class
1:1 Private session
To be filled in by all new students to xenoyoga when joining yoga class, workshop or yoga holiday.
All information given will be treated in the strictest confidence and stored in accordance with Data Protection legislation.
YOUR PERSONAL DETAILS
Date of birth
Address (including postcode)
Telephone number (+ country code) - Home
Telephone number (+ country code) - Mobile
Emergency contact name and tel. no
YOUR YOGA HISTORY / FITNESS LEVEL
Have you attended an Iyengar yoga class before?
how long have you practiced Iyengar yoga?
what style of yoga have you practiced and for how long?
How did you hear about us?
Do you participate in any other physical activity, e.g. gym work, jogging, swimming, aerobics, badminton, cycling, walking or other?
How regularly do you do this?
What would you like to achieve by practicing yoga?
YOUR HEALTH QUESTIONAIRE
The following information is required to ensure your safety. Whilst yoga may be practiced safely by the majority of people, there are certain conditions which require special attention. If you are unsure please consult your GP before commencing class. Please tick the boxes below if you have any of the following medical conditions.
These conditions require specific modifications to your yoga practice. If yes, please give details.
Abdominal disorder or recent surgery
Arthritis (osteo or rheumatoid)
Back pain (if known cause please state)
Shoulder or neck problems
High blood pressure
Low blood pressure
ME / Chronic Fatigue
Abdominal disorder or recent surgery - please give details
Arthritis (osteo or rheumatoid) - please give details
Back pain (if known cause please state) - please give details
Knee problems - please give details
Hip problems - please give details
Shoulder or neck problems - please give details
Heart disorders - please give details
High blood pressure - please give details
Low blood pressure - please give details
ME / Chronic Fatigue - please give details
Varicose veins - please give details
These conditions may affect your practice and so provide useful information for your teacher
Auto-immune disorder (e.g. M.E. M.S. Lupus etc)
Sensory disorder affecting eyes or ear
Balance affecting disorder
Frequent nose bleeds
Migraine / Headaches
Are you /could you be, pregnant, or have you given birth in the last six weeks?
If you have answered yes to any of the above or if you had any recent operations (in the last two years) / any old injuries that still trouble you / any other medical conditions not covered above that might be adversely affected by yoga practice, If yes, please provide details.
Iyengar yoga allows you to work at your own level to improve your flexibility, strength and general health. It is not competative and the postures can be adapted using props to assist in extension, and increase mobility. To avoid injury never force or strain yourself during the poses. Menstruating women should not do inverted poses, strong backbends or reverse standing poses. Pregnant women should be asked for specific advice. Those with special heath conditions should consult with their medical practitioner before performing any form of exercise / yoga classes. The teacher cannot be held responsible for any injury during the class, or any problem arising of a medical condition.
I confirm the above information is correct. I know of no reason of why I should not participate in any form of activity or exercise suggested to me by XENOYOGA. I acknowledge that any suggestions from XENOYOGA are neither diagnostic nor prescriptive. I understand that it is my responsibility to check with my doctor if I have any difficulties or concerns about my ability to participate in the yoga class and advice XENOYOGA of any change in my medical information follow the advice given by my doctor.
This field is for validation purposes and should be left unchanged.
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