Course Enrolment Form

Course Enrolment Form

Trauma Sensitive Yoga & TRE with Kendra
For a matter of both safety and courtesy, please answer the following pre-screening questions. The information obtained will be treated as confidential and will not be revealed to any person other than Kendra.

Returning participants please forward to payment and fill in any updated medical changes :)
Name*

First NameLast Name
Email for newsletter and communication*
example@example.com
Phone Number*
Please enter a valid phone number.
NDIS or concession card no.
Follow social media?

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Do you have any specific health goals or reasons for enrolling?
Have you been referred by your GP or mental health specialist? If so who?
Do you have any of the following now or in the past?

Complex or developmental traumaAutismClinical depressionAnxiety disorderPTSDHigh Blood pressureLow blood pressureHeart stroke conditionDiabetesEpilepsyArthritisAsthma or breathing difficultiesBack painRegular headachesAutoimmune disordersAre you pregnant or planningCancerDizzinessADHD/ADDBi-polarSchizophreniaPsychosisIrregular heart conditions (surgery, pace makers, arrhythmia)Hypo or hyperglycemia (medications)Physical limitations (brocken bones, strains, sprains, chronic aches)Other
Are you currently engaged in any physical activity?
Do you meditate or have you practiced any relaxation techniques?
Any other medical information?
Have you been hospitalized for psychiatric care in the last 6 months?
Do you have support from an ongoing therapist?
If yes, please include detail. We would never contact your therapist unless there is a clinical emergency. Is that ok with you?
Are there any issues you wish to share about triggers with yoga poses/breathing/lighting etc, that you have had in the past?
Are you currently taking medication on a regular basis?
Which classes/courses are you joining? All classes are trauma sensitive.*

Wednesday 12.30pm - 1.30pm TCTSY Kingston, Closed group courseWednesday 5.30pm - 6.30pm Rest & Resilience Kingston, Open group classFriday 9.30am - 10.45am Rest & Resilience Kingston, Open group classFriday TRE for 3, 11am - 12 noon Focus on Anxiety and Pain, In personFriday TRE for 3, 11am - 12 noon Focus on Anxiety and Pain, Online onlyFriday 5.30pm TRE for better sleep 3 wk Course, in person only
Sliding scale fees include GST. Please choose which fees feel appropriate for you. If attending a casual yoga therapy class, please process $35 or $30 concession prior to attending.
If creating your own yoga therapy term, please specify which dates you intend to attend and pay for - $35 per class or $30 concession.
Please transfer your payment today to confirm your booking, to;

Kendra Boone BSB: 313 140 Account: 124 280 98

Please note your name and preferred class on the payment description.

Please submit this form and click the orange 'register my spot' button at the bottom.
In my opinion there is no medical reason why I should not take part in the online or face to face Yoga Therapy Classes. I understand that all safety precautions will be observed but I agree to accept responsibility for any injuries that may be sustained whilst taking part in these classes.*

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Date signed*

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Terms and Conditions

My policies have been developed over the last 25 years and aim to give you flexibility in payment and encourage commitment to regular attendance.

As lessons are planned each week and considered a progressive program, it is important to commit your time in advance. This way, your yoga practice will flourish, and you will reap the health benefits yoga can bring.

Classes generally follow a school term and are approximately 8 to 10 weeks long.

Please carefully read the following policies. Your understanding is appreciated.

Class Fees

The class pass fee guarantees you a yoga mat space each week and shows your commitment for those weeks. A sliding scale of payment is offered so please consider your access to resources, and be a supporter where you can, so all may access the classes.

There are 2 ways you can make the term payment. By bank transfer or cash on the first day.

If you know you will not be able to attend the full term, please state which dates you intend to practice in the above box and pay $35 x the no. of dates.

Transfers

If you know you are unable to attend a class that has been prepaid, then you have the option of transferring to another class for that week. This is subject to availability.

Term fees cannot be transferred onto the following term if classes are missed.

Term enrolment may be transferred to another person.

Missed Class Policy

I highly encourage full attendance and your commitment to getting the most out of your practice. Missed classes must be paid for if paid weekly. There are now 2 classes to choose from on the timetable which allows for flexibility.

If you miss a class during your term, you are welcome to make it up at another class during the same term.

COVID disruptions

All classes are live-streamed and some are recorded to make it accessible when forced lockdowns or restrictions occur. Class credits are not given during this time.

Early Cancellation

Refunds will not be issued if requesting early cancellation but can be transferred to another class time.

Class Cancellations

Occasionally classes need to be canceled on short notice. All effort will be made to provide a make-up class after the term.

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