Class Registration
Fill out the form carefully for registration
Student Name
First Name
Middle Name
Last Name
Gender
Please Select
Male (he/him/his)
Female (she/her/hers)
Gender fluid (they/them/theirs)
I don’t identify with anything listed above
What class will you be attending?
*
Please Select
Sunset Sunday sept 14th 7:15-8:15
Sunday Sunday sept 21st 7:15-8:15
Are you comfortable with chanting “om” at the beginning of class?
Please Select
Yes
No
I will listen but not participate
Any chronic health issues / illnesses
Please Select
Yes
No
Are you comfortable with me offering physical adjustments to you in your yoga poses?
Yes
No
Have you recently had any injuries, if yes please let me know. (Helps to make the class more enjoyable for you)
Any sensitivity to smells (lavender, lemon grass)
Yes
No
How much experience do you have with yoga
Tried it here and there
At least a year
More then a year but <3 years
3+ I’m a yogi
Never done it
Anything else I should know?
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Submit
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