Tides Yoga Studio 1:1 Private Pole Appointment Application Form

1:1 Private Yoga / Pole Fitness / Dance Appointment Application

Your Place To Sparkle
Full Name*

First NameLast Name
Phone*

Area CodePhone Number
E-mail*
example@example.com
Health & Fitness Background
What motivates you to pursue 1:1 sessions, (please check all that apply)?

Personalized instructionFocus on specific skillsGreater flexibilityBuilding confidence in a private settingOther
What type of sessions are you interested in?

Personalized instructionFocus on specific skillsGreater flexibilityBuilding confidence in a private settingOther
Have you practiced yoga, pole dance, or dance before?

YesNoOther
What is your current level of experience in your chosen activity?

BeginnerIntermediateAdvanced
What are your fitness goals, (please check all that apply)?

Improve flexibilityBuild StrengthEnhance coordinationStress reliefLearn new skillsOther
Do you have any injuries or medical conditions we should be aware of?

YesNo
If yes, please explain
Do you prefer a specific instructor or style?
What are your expectations from these sessions?
How motivated are you to meet these expectations?

SomewhatVeryNot at allOther
Please describe in more detail any specific skills, techniques, & or goals you want to focus on:
How would your life improve from focusing on the above skills, techniques, & or reaching your goals?
What Times Are You Free If Your Application Is Accepted For A One Hour 1:1 Private Pole Session?

Tuesday’s 5:30 PMWednesday’s 5:30 PMThursday’s 5:30 PMFriday’s 6:30 PMFriday’s 7:30 PMSaturday’s 9:00 AMSaturday’s 10:00 AMSaturday’s 1:00 PMOther
Is there a Certified Instructor you prefer to train with?

Michele McCauley-OlsonHolly BoyleHannah OlsonSohnya Johnson
Any other comments or questions?
I acknowledge that I have provided accurate information to the best of my knowledge. I agree to inform my Instructor of any changes to my health or fitness status. And that I am responsible for purchasing my 1:1 session(s) if my application is accepted before my 1:1 session(s) will be scheduled. I am also responsible for giving twenty four hours notice if I am unable to attend my session or I will forfit the session.
Signature*

Clear
Date

MonthDayYear
Date
We look forward to the posiblity of working with you at Tides Yoga Studio. After reviewing you responses, we will determine if our studio is the right fit for your goals & aspirations. We will get back to you withing 36 hours.

Sincerely,

Sohnya Johnson

Owner, Tides Yoga Studio
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1:1 Private Yoga / Pole Fitness / Dance Appointment Application

Health & Fitness Background