SUP health questionnaire

Sup Yoga and Sup Fitness Health Questionnaire

This questionnaire has been designed to help you to enjoy your session safely. All information given will remain private and confidential.

NameAddressEmail AddressTelephone numberDate of BirthOccupationGenderEmergency Contact NameRelationshipEmergency Contact numberPlease tick if you would like to be on the mailing list for workshops, retreats and classesYes, please

Health Information

Do you have any health conditions asthma, heart conditions, etc.?Are you taking medication that we should know about?
Do you have any physical limitations or injuries that we should be aware of?
Back conditions, knee/shoulder problems, recent surgery, etc.?

Yoga Experience

Have you ever practiced Yoga? If so, how often do you currently practice?

SUP Experience

What Sup experience do you have? Have you ever done Sup Yoga or Sup Fitness?

Swimming Ability

All participants taking part in Sup Yoga or Sup Fitness must be able to swim a minimum of 50 meters (i.e. 2 lengths of a 25m swimming pool). Please confirm this.
Yes, I can swim 50 meters

Other Information

If there are any other conditions that may affect your participation, please detail them
below:

With regards to all forms of exercise if you have any doubt about your level of health and
fitness it is advisable to consult your GP prior to the commencement of Sup Yoga or Sup
Fitness session. The instructor must be informed of any injuries, handicaps or medical
problems prior to joining the session. Sup Yoga Bournemouth Zoe Lee cannot accept
responsibility for personal injury whilst participating in Sup Yoga or Sup Fitness sessions if:
a) You have been advised against exercise on the basis of a pre-existing health condition by your GP.
b) You fail to observe the techniques and instructions given regarding safety.
I acknowledge that I exercise at my own risk.

I acknowledge that I exercise at my own risk.

Thank you! Your submission has been received!

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