Course Registration Form

Student Registration Form

Fill out the form carefully for registration
Whole Body Breathing 6 week course online

Welcome and thank you in advance for completing this form.
Student Name

First Name Middle Name Last Name
Gender
Student E-mail
How did you find out about this course?
In what country or time zone will you be ?
Have you practised Yoga before ? If so which of these?

with a friend or teacher on my own with the help of books or recordings taken courses on retreat
Please can you write a little about your yoga experiences , which teachers, styles...
What interests you about joining this 6 week course now ?
Do you have any past or present sleep or eating issues, health or mental health issues ?
Is there anything else you wish Julie to know ?
By participating, you take on the responsibility to let us know if you don't want to be recorded during the sessions. I may also share some or all recordings publicly.

I agree
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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Student Registration Form