Universal Healing Studio Registration & Liability Waiver Form Participant Details Full Name * Date of Birth * Phone * Email Address * Mailing Address * City / Province / Postal Code * Emergency Contact Contact Name * Relationship * Emergency Phone * Health & Wellness Injuries / Medical Conditions * Are you pregnant? * Select option Yes No Not Applicable Experience Level * Select level Beginner Intermediate Advanced Class Preferences Select Class Type * Choose class type Yoga Vinyasa Restorative Meditation Breathwork Healing Preferred Days / Time * Waiver & Consent I accept full responsibility and confirm I am physically/mentally able to participate. I waive all claims against Universal Healing Studio and agree to hold it harmless. This agreement is governed by the laws of Alberta, Canada. I consent to photo/videos being used for promotional purposes. I have read and fully understand this registration & waiver form. Final Authorization Legal Name (Print) * Today's Date * Digital Signature * Submit Registration
