Provide full address.
Street Address Line 2
State / Province
Postal / Zip Code
Date of Birth
Comfortable with Alignment Principals
Fluent in Pranayama
Knowledge fo Bandhas and their use
Main Reason for Taking Class
What is the date of event/class? (it this is an ongoing event - just write in the first date of series)
Concerns? (Example: Pregnant, Can't be on knees, Spinal Stenosis, Herniated Disc, etc - anything here you list helps a Yoga teacher design their class. Please be as specific as possible.
(Please write NONE if that applies)
If you would like a coupon for our studio: 4 Classes for $25 - please share your email!
COVID-19 or ANY Contagious illness
By submitting this form, I agree to not attend the Yoga Session if I have been in contact within 14 days of someone with COVID-19, as well as I do not show ANY symptoms of COVID-19 or any other contagious illness. We will do the same. During the pandemic, we secure a back up just in case!
Signature (agreement to intake form/terms & conditions
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