Membership application and declaration form

Important information
Yoga positions and classes may pose difficulties for persons with some
disabilities or medical conditions. Female students if menstruating, pregnant
or trying to conceive are also advised to avoid certain postures and activities.
In the interests of your wellbeing, you should always seek qualified medical
advice from your General Practitioner or consultant if you are pregnant,
trying to conceive, or have a medical condition or disability which might
affect your ability to practise Iyengar yoga.
Membership
Whether you are an existing or new student we recommend that you discuss
privately with your class teacher whether the class you wish to attend is
suitable for you.
The Iyengar Yoga Institute Maida Vale takes seriously its obligation to treat
people with disabilities fairly and to make reasonable adjustments. However,
not all our teachers are qualified to a sufficient level to teach persons with
disabilities and we may not have a suitable teacher available.
DECLARATION (Please complete A or B)
A
I consider myself to have a disability or medical condition and have sought qualified medical advice and been told I may practise
Iyengar Yoga and similar strenuous physical activities.
The following adjustments are required:
B
I do not suffer from any condition which could affect my ability to
practise Iyengar Yoga and similar strenuous physical activities.
I accept that failure to disclose a pre-existing condition or making a false declaration
can result, in the case of an accident or injury, in the denial of liability except where
IYIMV its officers, agents or employees have been negligent.
Signed Date
Please print and sign this form and bring it with you to the Institute. You may also
save a copy of this form to your computer and send it to the Institute by email. You
will be required to sign the form on your arrival.
Iyengar Yoga Institute Maida Vale
223a Randolph Avenue
Maida Vale
London
W9 1NL
020 7624 3080
[email protected]
www.iyi.org.uk
About Membership
Membership Form As a Member you are eligible for discounted classes at our historic building
which was the first purpose-built yoga studio in Europe. It is also where BKS
Iyengar, known as the father of modern yoga, called his home in the UK.
We ensure our Members are taught by the most experienced teachers in
the country and are proud to uphold internationally recognised standards for
Iyengar yoga teaching and study.
First Name
Last name Address
Post code
Running the Institute as a Membership organisation means we can keep the
prices of our classes and events low. We offer Members’ rates on all classes
plus priority booking with reduced rates on all events and workshops. Find
details about our prices and Member rates on our website.
(Please print clearly)
City
Telephone
Email
Emergency contact name and number
We are a charitable, not-for-profit organisation and are run by an elected
Board of Trustees. After one year of membership, Members can stand for a
position on the Board and vote at our general meetings. As a Member you will
receive our annual journal ‘Dipika’ with advice and insights into yoga
plus regular newsletters.
Male / Female (delete as appropriate)
D.O.B
How did you hear about the Institute?
Save with Annual Membership
subscription rate: £55 per year
We offer Annual and Three Month Membership. If you plan to come to yoga
twice a month or more it is better value to take out Membership for a full year.
[ ] Tick here if you do NOT want to get class updates, offers and newsletters from
IYIMV by email
Annual Membership
Three Month Membership
£55
£25
£25 for 3 months
credit card or cash payment only
IYIMV agrees not to release your details to any external party without first seeking your permission. The information on this form is
collected, stored and processed for the purposes of IYIMV membership or company administration. IYIMV does not sell or exchange
membership lists with other organisations.
PLEASE TURN OVER
Office use only
Payment details
Terms and Conditions: Memberships are non-refundable and cannot be extended. Late
renewals are backdated. Visitors are welcome to attend drop-in to classes for up to one
month before taking out Membership.
Subscription
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