Mindful Yoga Registration and Waiver with Natalia Fister

Course information:
This style of yoga encourages mindful conscious movement according to the needs of each individual body. Appropriate for beginners and varying abilities.

Payment details: please E-transfer Natalia Fister:
Natalia.Fister@mindfulnesseveryday.org or Nataliafister@me.com

For more information, contact: Natalia.Fister@mindfulnesseveryday.org

1Personal Information > 2 > 3Review Your Entry
Name Name * First Last
Email *
Preferred Phone Preferred Phone * - ### - ### ####
Which day(s) will you be attending?
What gender do you identify with? *

What gender do you identify with? Male Female Other Other
Age *

Age 0-25 26-35 36-45 46-55 56-65 65+
Allergies &/or physical requirements
Before teaching mindful movement, we want to get to know any physical limitations you might have so we can keep you safe.

Here is a list of common physical limitations. Please check the ones that apply to you. You are not alone.

Before teaching mindful movement, we want to get to know any physical limitations you might have so we can keep you safe.

Here is a list of common physical limitations. Please check the ones that apply to you. You are not alone. Lower back pain • Osteoarthritis of the back • Osteoporosis/osteopenia Sciatica SI joint pain Carpal Tunnel • Arthritis in the wrist/fingers Shoulder/Rotator Cuff injuries • Frozen Shoulder • Bursitis/Tendonitis of Elbows or Shoulders Knee injuries • Arthritis in the knees Glaucoma • Eye infection Pregnancy • Hernia • Abdominal Surgery Prone to headaches • Migraines Dizziness Ankle injury • Arthritis in feet Hernia or any recent abdominal surgery Hip replacement Hamstring injury Scoliosis Pregnant Epilepsy IBS Constipation Diarhea Other Other
A) Please expand /give more details so that I can modify and keep you safe :)
B) What is your level of experience in yoga? What styles?
Referral Source:

Referral Source: Mindfulness Everyday Website Mindfulness Everyday Newsletter Social Media Colleague Other Other
Any other information that you’d like us to know