Anatomy & Physiology Course Application Form

Vinyasa Yoga Foundation Course

Participant Registration Form
Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
E-mail*
example@example.com
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name*

First NameLast Name
Emergency Contact Number *
Please enter a valid phone number.
Yoga Background
How long have you been practicing yoga?
What style(s) of yoga do you practice/teach?
Have you completed any yoga teacher training before? If Yes, please provide details of the training(s):
What do you hope to gain from this course?
Health Information (Optional but Recommended):
Do you have any medical conditions, injuries, or physical limitations we should be aware of to ensure your comfort during the course?(Yes/No)*

YesNo
If Yes, please briefly explain:
Course Fee

Date: SUNDAYS
19 & 26 APRIL 2026
3 & 10 MAY 2026

Location:8a, Jalan Vermont, George Town, Penang, Malaysia

Early Bird Pricing: RM520 ( Until 31 March 2026 )

Regular Pricing: RM650 ( 1 April Onwards )

Payment Methods: Local Malaysia - Bank Transfer Public Bank 3176856006 De Yoga House or E-Wallet at 0125101122 Instructions: Please screenshot your payment reference and attach a picture in the required field below before submitting this form. Once payment has been verified, you will receive an email to confirm your registration.
Terms & Conditions
By registering for and attending the Yoga Anatomy & Physiology Foundation Course, you acknowledge and agree to the following:
- Participation & Responsibility
  This course involves physical movement, demonstrations, and practical application. You agree to take full responsibility for your own physical and mental well-being and to participate mindfully and within your personal limits.
- Liability Disclaimer
  The organizer and instructor accept no responsibility for any injury, loss, or damage to your physical body or mental health that may occur during the course, except where such injury or damage is proven to be caused by negligence.
- Health Declaration
  You confirm that you are physically and medically fit to participate in this course. It is your responsibility to inform the instructor of any injuries, medical conditions, or limitations prior to the start of the course.
- Payment Policy
  All payments made are non-refundable. However, registrations are transferable to another participant with prior notice to the organizer.
- Attendance & Punctuality
  Participants are required to arrive at least 15 minutes before each session begins. Late arrivals may not be permitted to join once the session has started, to ensure safety and minimize disruption.
- Personal Belongings
  The organizer is not responsible for the loss or damage of personal belongings during the course.
- Media Consent
  By attending the course, you consent to photographs or videos taken during the sessions being used for promotional and educational purposes. If you do not wish to appear in any media, please inform the organizer before the course begins.
- Course Changes
  The organizer reserves the right to make reasonable changes to the course schedule, venue, or content if necessary.
- Agreement
  By signing and submitting this form, you confirm that you have read, understood, and agreed to all the terms and conditions stated above.
I had read and agree to the Term & Condition above.
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Vinyasa Yoga Foundation Course

Yoga Background

Health Information (Optional but Recommended):