Yoga

Yoga

Thank you for taking out the time to fill this form. Your honest answers will help in creating the right yoga classes for you. This information will be kept confidential.
Client Name*

First NameLast Name
Birth Date*

MonthDayYear
Date
Residence*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Email*
example@example.com
Occupation*
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area codePhone Number
Have you practiced yoga before?*

YesNo
If you selected ‘yes’ in the previous question, please share how often you practice yoga.

Very regularly (a few times a week)Average (once a week)Not that much (once a month)
Which style(s) of yoga have you practiced?
What are your goals/expectations from your yoga practice? What benefits are you looking for? (Select all that apply)*

StrengthFlexibilityMobilityBalanceStress relief and managementPositive reinforcementInjury rehabilitationWeight managementNot sure yet
Which areas of yoga would you like to focus on/are more interested in? (Select all that apply)*

Pranayama (breathing techniques)MeditationAsanas (physical postures and exercises)Not sure yet
How would you rate your current level of physical activity?*

Sedentary/very inactive (no exercise at all)Somewhat inactive (once a week)Average (twice a week)Fairly active (three times a week)Extremely active (four to six times a week)
On a scale from 1 to 5, how would you rate your level of stress?*

1

2

3

4

5

1 is Worst, 5 is Best
On average, what is your energy level like most days?*

Low energyModerate energyHigh energy

Please select the conditions that have either affected your health recently or in the past.*

	Yes	No
Broken/dislocated/fractured bones
Muscle strain/sprain
Arthritis or bone-related diseases
Diabetes type 1
Diabetes type 2
High blood pressure
Low blood pressure
Insomnia
Anxiety/depression
Surgery
Eye problems
Pain in any part of the body
Pregnancy
PCOS/any other hormonal problem
Poor mobility/movement limitations in any part of the body
Asthma/any other respiratory weakness
Heart problems
Spinal disorders
Cancer
None

If you selected any of the above conditions, please provide more detail (e.g. time of diagnosis, symptoms and any other details your yoga instructor should know).
If there is anything else you want to share, please do so below:
Please select your plan of choice.
prevnext( X )
16 sessions4 sessions/week
19,200PKR



12 sessions3 sessions/week
14,400PKR



8 sessions2 sessions/week
9,600PKR



Total

0.00PKR
All payments are made through direct bank transfers. Please attach a screenshot of your payment receipt after completing it.

Cancelof
Bank: Allied Bank Limited

Account name: Mariyah Bintey Imran

IBAN No: PK74ABPA0010058379140010
Terms and conditions
1. If at any point the client feels unwell and/or experiences pain or discomfort, she must notify the instructor immediately. This includes any rising medical conditions that the client feels may affect or be affected by doing exercises.
2. The client must notify the instructor when she is on her period or is pregnant. This is to ensure the safety and wellbeing of the client. Some exercises/poses can not and should not be done during both conditions and must not be taken lightly.
3. Any sessions postponed or missed by the instructor will be rescheduled.
4. Every session will have a 10-min waiting time. If the client does not show up for her session within those 10 mins without prior notification, that session will be canceled and will not be rescheduled.
5. Keeping in mind the unpredictable nature of clients’ work and home lives, the session timings can be changed or delayed, if notified at least 30 mins before the session starting time.
6. Whether the client opts for a 45 min session or less, the monthly cost will remain the same. This payment is non-refundable and has to be paid in advance. Once the payment has been made, the client will be able to begin her sessions.
7. Sessions that have been postponed can not be re-postponed.
8. Clients may postpone 1 week’s sessions. Any sessions postponed beyond that number will be considered cancelled and will not be rescheduled.
9. The client must utilise her sessions within 5 weeks of the purchase date. A new cycle of sessions will begin after 5 weeks.
10. The client must keep her yoga teacher up to date on any rising or resurfacing medical conditions.
11. The client must ensure there are no men in the view of the camera and session screen during yoga sessions. This is to protect the modesty and privacy of the yoga instructor. If this is not possible (due to any reason), the trainer must be notified so that appropriate measures can be taken at her end.
12. The online fitness sessions are held in a room that is closed and covered on all ends to maintain the privacy and modesty of online clients.
13. Medical and contact information (and any other private information shared during online yoga sessions) of the clients is confidential and is not shared with any other person.
14. The client may share the instructor’s personal contact information with potential clients.
15. Any feedback and constructive criticism from the client is highly appreciated and will help in improvement of services.
I agree to the terms and conditions listed above.
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Yoga

Terms and conditions