Registration Form

(please print out and send or bring with your payment)

All of the teachers at THE BARN are independent contractors.

To secure your place in a class or workshop:

Call The Barn (207-798-5884).

Or contact the teacher offering the class via phone or e-mail.

To register for a class:

Print and complete this form.

Mail/bring your check, payable to the teacher, to The Barn

How did you hear about THE BARN?

Family  Friend  Co-worker  Web  Phone  book

Flier (where?)___________________ Other__________________________

If you’ve registered before, please note any changes. Thank you.

Today’s date __________________

Name ________________________________________

Street address _________________________________

City, State, Zip _________________________________

Phone: home- ________________________

   work- ________________________

   cell- _________________________

   e-mail ________________________

Class or workshop selection:

Day         Time         Class               Instructor             #of Weeks              Cost

__________________________________________________________________

Informed consent and Waiver of Liability:

The practice of yoga includes physical exercise and a risk of injury. It is advisable to consult your physician before embarking on any exercise instruction. As professional level yoga instructors we are responsible for providing you with competent yoga instruction. We here at THE BARN are not responsible for safety beyond providing competent instruction.  Your signature below releases THE BARN, Ann Flannery and all other instructors at THE BARN from any and all liability for injuries that are not directly and proximately caused by our professional negligence. I have read, understand and agree to the content of this professional Disclosure Form and Release.

Signature____________________________________Date__________________