Give yourself the gift of relaxation

Name: Asanda Yoga & Massage
Address: 10035 French Settlement Road, Kemptville, ON, K0G 1J0, CA
Telephone: 613-612-7940

Therapeutic Yoga Classes & Hot Stone Massage

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About

Tania Wlotzki
Registered Yoga Teacher

Tania is a certified restorative hot stone yoga Instructor and a registered yoga teacher (RYT Hatha 200). Tania's journey started when searching for healing alternatives for herself. She found a love for yoga and now enjoys teaching nourishing and relaxing styles, with a strong focus on nurturing the nervous system. Tania believes that one of the best gifts we can give ourselves is the gift of relaxation!

Services

Restorative Yoga

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Registration forms

These registration forms are to be filled out one-time only if you sign up for Asanda Yoga & Massage services. If you’ve done so in the past, thank you. If your contact information or circumstance change (e.g., medical conditions or injuries), please submit a new form.

Yoga Form

First Name

Last Name

Phone

Message

Have you ever done yoga before?

Yes

If you are pregnant, what trimester are you in and when is your due date?

Please list any pre – existing medical conditions or injuries, and/or important medical history:

Is your Dr aware of your participation in Yoga?

Yes

I agree to the Release and Waiver of LiabilityView here

Massage Form

First Name

Last Name

Phone

Message

Have you ever done yoga before?

Yes

Please list past surgeries, injuries, broken bones, locations of pacemakers, wires, artifical STIs

Are you undergoing any forms of treatment?

Do yo have any allergies to scents?

Yes

I agree to the Release and Waiver of LiabilityView here

Tania Wlotzki

613-612-7940 | AsandaYoga4u@gmail.com

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