Mama & Baby 6 week course Student Registration Form
Fill out the form carefully for registration
Welcome and thank you in advance for completing this form.
Student Name
First Name
Middle Name
Last Name
Phone Number
-
Area Code
Phone Number
Gender
Male
Female
N/A
Student E-mail
Why would you like to join this 6 week course / Que te motives para participar en el curse ?
Please can you tell us if you have any experience of yoga , if so please tell us about it / Por favor , podrias comparitr si tienes alguno experiencia previa de yoga?
How old is your baby/ De que edad es tu bebe?
Can you please share a little about your pregnancy and the birth / Por favor , podrias compartir un poco del embarazo y party?
Please tell us anything else you wish me to know about your baby/ Hay alguno cosa mas que queries compartir con nosotros de tu bebe?
Do you have any health issues , back pain or injury or other/ Si tienes alguno lesion o problem de salud ?
Do you have any past or present sleep or eating issues, health or mental health issues / Tienes alguno historia de salud mental o salud ?
To register for this course please confirm below that you are over 18 years of age and fully responsible for your mental and physical health.
I agree and confirm
" I will not share course materials nor the sharing of other participants with anyone else. I commit to keeping all communications confidential"
I agree
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