Thank you!

Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Birthdate *

MUST BE 19+

MM

DD

YYYY

Alcohol intake

Never

Occassionally

1-2 x a week

3-5 x a week

Daily

Cannabis practice *

None

THC

CBD

THC & CBD

Would you like to enhance this practice? *

No

Only THC

Only CBD

Both THC & CBD

Unsure

Liability *

If at any time during class you feel discomfort or strain, gently come out of the posture. You may rest at any time during class. it is important in this practice that you listen to your body, and respect it's limits on any given day. I understand that the use of cannabis and yoga are not a substitute for medical attention, examination, diagnosis, or treatment. I should consult a physician prior to beginning any activity program, including yoga. I recognize that it is my responsibility to notify my teacher of any serious illness or injury before every yoga class. I will not perform any posture of strain or pain. I am 19 years or older. I accept that neither that instructor Sarah Hatter, nor the hosting facility SHYpractice is liable for any injury, or damages, to person or property resulting from the taking of this class

I Agree

I disagree