Consent Form Trauma Sensitive Yoga Consent FormThis form must be completed before workshops begin. Name * First Name Last Name Date of Birth * MM DD YYYY Age Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email Address * Home Phone (###) ### #### Work Phone (###) ### #### Cell Phone * (###) ### #### How did you hear about this workshop series: Calls or email contacts will be discrete, but please list any restrictions: May I thank this person for the referral? Yes No May I add you to my mailing list? (Being added to our mailing list will allow you to receive monthly newsletters that tell you about classes, groups and workshops at The Center. Your information is never shared with anyone else and you may unsubscribe at any time.) Yes No YOGA INFORMED CONSENT The following information will help you get the most out of this yoga series. Please read and sign below.By choosing to participate in this yoga series you voluntarily assume a certain risk of injury however, this type of yoga practice has minimal risk of physical injury. Any practice of yoga is an invitation into the subjective experiences of being. Keeping this in mind, this practice invites you first and foremost to listen to your own bodies and be guided by your own experiences in the moment. Essentially, this yoga practices is a practice of self-inquiry and self-care. The following themes will guide this practice: 1) The importance of the present moment2) Making choices3) Taking effective action4) Creating rhythms. With this in mind, respect your body’s abilities and limitations.Do not perform forms or movements that are painful.If you are unsure how to perform a certain movement, your instructor will provide visual and verbal assists. Physical assists will not be performed during this series. As your instructor, I recognize that triggers may naturally arise during a yoga class. If this is the case, participants will be invited to utilize yoga techniques to manage some of the triggered reactions in the moment. It is highly recommended that students process anything that arises in yoga classes with his or her psychotherapist. Finally, please inform me of any health conditions that could be affected by your practice of yoga. If you are unsure about a condition, feel free to speak with me. I am responsible for providing competent yoga instruction. However, as a student you are encouraged to monitor each activity and determine if it is appropriate for you to engage in the activity. Making choices and taking effective action is encouraged and of the utmost importance during this series. By signing this form, you hereby release Kara Cavel of any and all liability for injuries that are not directly and proximately caused by professional negligence. I have read, understand and agree to the content of this Yoga Informed Consent Form: * I have read, understand and agree to the content of this Yoga Informed Consent Form: Name/Signature * Date * MM DD YYYY Thank you!
