Online and in studio booking for Hoop Icon 2021 Workshops Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Cell Number *ID Number or Passport Number *Address Emergency Contact Name *FirstLastEmergency Contact Cell Number *My Bookings *February 20th Saturday Hoop Advanced 13:15 to 15:15 R 300.00 in studio bookingFebruary 20th Saturday Hoop Advanced 13:15 to 15:15 R 150.00 Zoom bookingFebruary 21st Sunday Hoop Intermediate 1 10:00 to 12:00 R 300.00 in studio bookingFebruary 21st Sunday Hoop Intermediate 1 10:00 to 12:00 R 150.00 Zoom bookingFebruary 21st Sunday Hoop Beginner 12:15 to 14:15 R 300.00 in studio bookingFebruary 21st Sunday Hoop Beginner 12:15 to 14:15 R 150.00 Zoom bookingMarch 9th Tuesday Hoop Intermediate 2 17:00 to 19:00 R 300.00 in studio bookingMarch 9th Tuesday Hoop Intermediate 2 17:00 to 19:00 R 150.00 Zoom bookingYou will be invoiced for the selected workshops, depending on availability, once your form has been received. Once the invoice has been paid you will be added to the workshop(s) you have chosen. Due to COVID regulations and necessary social distancing only 5 spots are available per workshop for in studio bookings. A Zoom link will be provided for participants who wish to attend online.Medical Clearance *I confirmI UNDERSTAND THAT IF I HAVE ANY MEDICAL CONDITION OR INJURY, I MUST GET CLEARANCE FROM MY GENERAL PRACTITIONER TO DO EXERCISE. I MUST SUBMIT THE CLEARANCE LETTER AND THE NECESSARY INFORMATION TO MY INSTRUCTOR BEFORE I COMMENCE TRAINING. Safety Agreement *I confirmI CONFIRM THAT IF I FEEL UNCOMFORTABLE PERFORMING AN EXERCISE, I WILL DISCUSS IT WITH MY INSTRUCTOR. IF I FEEL UNWELL OR EXPERIENCE ANY PAIN, I WILL STOP THE EXERCISE. COVID-19 Test *I confirmI CONFIRM THAT IF I HAVE BEEN TESTED FOR COVID-19 IN THE LAST 14 DAYS THE TEST RESULT WAS NEGATIVE. Low Bookings Policy *I confirmI UNDERSTAND THAT IF TWO PEOPLE OR FEWER ARE BOOKED FOR A CLASS, IT WILL BE CANCELLED OR I WILL HAVE THE OPTION TO PAY FOR A PRIVATE CLASS INSTEAD.Cancellation Policy *I confirmI UNDERSTAND THAT MY CLASSES ARE BOOKED AND PAYABLE IN ADVANCE. IF I DO NOT CANCEL A CLASS AT LEAST 24 HOURS IN ADVANCE, FULL FEES WILL BE FORFEITED, REGARDLESS OF THE CIRCUMSTANCES. Do you have any of the following symptoms: Fever, cough, sore throat, aches, pains, headache, shortness of breath, chest pains?NoYesHave you been in contact with any person with COVID-19 when you were not wearing PPE in the last 14 days?NoYesDo you feel pain in your chest when you perform physical activity?NoYesDo you lose balance because of dizziness, or do you ever lose consciousness?NoYesDo you have a muscle, nerve, bone or joint problem?NoYesAre you pregnant?NoYesDo you smoke?NoYesHave you ever had any surgeries, injuries or chronic pain?NoYesAre you currently taking any medication?NoYesDo you have any vision or hearing problems?NoYesHas a medical doctor ever ever diagnosed you with a chronic disease?NoYesDo you know of any other health-related reason why you should not engage in physical activity?NoYesDetails on physical/medical conditions or medicationPlease give detail if you have answered yes to any of the above. Declaration *I confirmI CONFIRM TO THE BEST OF MY KNOWLEDGE THAT ALL INFORMATION DISCLOSED IS CORRECT AT THE TIME OF COMPLETION. I CONFIRM THAT I WILL INFORM THE LYRA PROJECT SHOULD I BE DIAGNOSED WITH COVID-19 SO AS TO FACILITATE CONTACT TRACING. WebsiteSubmit