ELDOA

Name*

First Last

Email*

Date of birth*

Pronouns / Preferred Names*

Phone

What type of support are you looking for? (select all that apply)

Strength Training
ELDOA / Corrective Exercises / Pilates
Postural Correction / Mobility / Flexibility
Introduction To Movement/ Fitness / Training
Other / Not Sure

How Motivated are you to achieve your goals?*

LET'S DO THIS!!!
100% right now, but I'll need help later on
An honest 75% (it varies day to day)
I'm here cause I HAVE to DO something - I need lots of help with motivation
I'm not motivated to answer this question

Everyone is unique. What do YOU want to achieve in our time together?*

ELDOA/Personal Training Rates:*

Total

$ 0.00 CAD

Waiver*

I agree to all terms outlined within this waiver

RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTIONS OF RISK AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY!
ASSUMPTION OF RISKS & RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY
I am aware that the readings, resources and my participation in one-on-one coaching (in person or online), group classes, workshops or other offerings could, in some circumstances, result in emotional or mental distress, and have discussed my participation, where applicable, with my physician.
I acknowledge that none of the services offered by Sharmeen Bhanji-Abeysinghe are of a psychotherapeutic in nature or a replacement for qualified mental health care.
In consideration of the acceptance of participation in coaching, classes, webinars, workshops or trainings offered by My Aligned Life / Sharmeen Bhanji-Abeysinghe for myself, my heirs, executors, administrators and assigns, waive any claims to which I may become entitled for injury or damage and WAIVE ANY AND ALL CLAIMS that I have or may in the future against Sharmeen Bhanji-Abeysinghe / My Aligned Life and any of it’s clients, instructors or employees.
I also acknowledge that my participation in one-on-one coaching (in person or online), group classes, webinars, workshops or any other offerings, offered through My Aligned Life / Sharmeen Bhanji-Abeysinghe, supports a safe space and learning community to all participants. As such, we expect all participants to engage in respectful conduct at all times. This includes the receiving and sharing of personal information, experiences and advice, both in person and in all social spaces, connected with the program(s). Behaviors that violate our standards of conduct will not be tolerated and may result in removal from the program and all associated social spaces.
I RELEASE My Aligned Life / Sharmeen Bhanji-Abeysinghe from any and all liability for any loss, damage, injury or expense that I may suffer as a result of participating in the programs offered by Aligned Life / Sharmeen Bhanji-Abeysinghe due to any cause whatsoever. INCLUDING NEGLIGENCE, BREACH OF CONTRACT OR BREACH OF ANY STATUTORY OR OTHER DUTY.

Consent*

I agree

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eldoa

ELDOA Group Classes

ELDOA Private / Semi-Private Sessions

ELDOA/Personal Training Rates:

ELDOA/Training Sessions

What is ELDOA?