New Client FORM

Once you submit your application, you will receive an invitation to purchase your first session or package, if you have not already done so. please E-mail for scheduling. 


Name *
Phone *
Address *
Do you have yoga props? *
I require my new yoga clients to have a standard set of yoga props - yoga mat, two blocks, yoga blanket, and yoga strap. Do you have these? Otherwise, I'll send a link to purchase this new client yoga kit which will be delivered to your home prior to your first session.
Please review and acknowledge below. *
RELEASE & WAIVER OF LIABILITY I agree to the following: 1. The information I have provided above is complete and accurate. 2. I understand that I am participating in yoga conditioning sessions offered by Fern Langham. I recognize that yoga requires physical exertion that can be strenuous. I am fully aware of the risks involved. 3. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in yoga. I represent and warrant that I am physically fit and have no medical conditions that would prevent me from participation in yoga sessions. I assume full responsibility for any injuries or damages, known or unknown, which I might incur as a result of participating in yoga conditioning sessions. I knowingly, voluntarily, and expressly, waive any claim I may have against Fern Langham for injury or damages that I may sustain as a result of participating in the program. 4. I understand that in the event that I need to cancel a scheduled yoga session, I must do so at least 48 hours in advance, otherwise I will be charged the full amount of the session.