1. Have you/has the student had any surgery or serious illness in the last 4 years?

2. Are you/is the student suffering from any medical condition?

3. If you are/the student is receiving treatment from a medical practitioner, have recently had surgery or a serious accident or illness, or are on medication, please confirm that you have checked with Sarah Delfas to see whether this class is suitable for your condition.

4. I accept and agree that participation in live online classes with Sarah Delfas is at the student's own risk. If the student named above is under 18 I am the student's parent or guardian named above.