BYE - Student Registration

username and password are case sensitive password must be at least 6 characters long

	*	Required Field

First Name	*
Middle Initial	*
Last name	*
Gender	*	Female Male

Username	*
Password	*
Confirm Password	*

Address Line 1
Address Line 2
City
Province/State
Postal/Zip Code	*
Country	*

Phone	*	(Format 000-000-0000)
Extension

E-mail	*
Confirm Email	*
Email Contact Permissions
Receipts
Schedule Changes and Updates
Special Events
Newsletter
We will not share your email address with anyone.

Referred by

List medical conditions and/or injuries


Emergency Contact
First Name	*
Last Name	*
Relation
Phone	*	(Format 000-000-0000)

I have read and accept the following agreement.
By enrolling me as a student of Bikram Yoga Edmonton Inc. (BYE), I agree to the following: I have been examined by a licensed physician within the last 6 months and have been found by such pyhysician to be in good healthy and fully able to perform all Yoga exercises which will learn and perform during my enrollment with you. I will faithfully follow all instructions given by you and your associated Yoga instructors as to when and how to perform and not to perform Yoga exercises, it being understood that such deviation by me from such instructions shall be at my own risk. I will not hold BYE, its owners and associated instructors, responsible for any injuries suffered by me caused whole or in part by my failure to follow the instructions given, or by any physical impairment of mine not fully disclosed to you in writing. I understand and acknowledge that I am to receive instruction in Yoga theory and exercise only, and will not hold BYE, its owners and associated instructors, to any higher standard of care than applicable to the school of Yoga thoery and exercise.

* I have read and accept

username and password are case sensitive password must be at least 6 characters long

Email Contact Permissions

We will not share your email address with anyone.

Emergency Contact

I have read and accept the following agreement.

username and password are case sensitive
password must be at least 6 characters long