Student Registration Form

Student Registration Form

學生報名表
Name*

First NameLast Name
Gender

FemaleMale
Phone Number*

Area CodePhone Number
Date of birth*

MonthDayYear
Date
Email*
example@example.com
Emergency contact person & phone number *
Name & phone ☎️
Occupation *
Do you have any medical condition/ physical injuries/ pains? If Yes, please specify
EXAMPLE : knee or joint pain, neck & shoulder pain, lower back pain, depression, heart disease, high or low blood pressure, scoliosis, sciatica, insomnia, hernia, arthritis, asthma, glaucoma, gastroesophageal reflux disease .....etc
How do you know about us

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Terms & conditions :

1. The Applicant recognizes that yoga exercises require physical exertion, which may be strenuous and may cause physical injury, and he/she agrees to assume full responsibility for any risks, injuries or damages, known and unknown, which he/she might incur as a result of participating in the classes, and hereby knowingly, voluntarily and expressly waives any claim against the instructor(s), the Organizer, or the owner(s) of the premises for injuries or damages that he/she may sustain as a result of participating in the classes.

2. All payments are final, non-refundable, non-cancellable and non-transferable.
I, the applicant, hereby agree to the above terms & conditions*

I Agree
WE ACCEPT

1. Bank Transfer / FPX

Public Bank

323 487 3202

Turiya Yoga Meditation Studio

2. Touch n Go

🪷Registration fees RM50

⭐️4 classes RM160 (valid for 30 days)

☀️10 classes RM380 (valid 3 months)

Namaste
Please upload the receipt of the payment, thanks *

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