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Pranalaya Private Class Registration Form
1
FULL NAME
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Please enter the name of the main contact person for this booking.
First Name
Last Name
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2
ADDRESS
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Street Address
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Town / City
Province
Postal / Zip Code
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Poland
Portugal
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Romania
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Saint Helena
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Saint Lucia
Saint Martin
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Samoa
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Saudi Arabia
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Serbia
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Somaliland
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eSwatini
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Switzerland
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Taiwan
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Tanzania
Thailand
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Togo
Tokelau
Tonga
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Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
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United Kingdom
United States
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Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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3
E-MAIL
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4
PHONE NUMBER
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Area Code
Phone Number
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5
Are you fully vaccinated against Covid-19?
*
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Only fully-vaccinated individuals may book a class. If you are not yet completely vaccinated, please present a negative Covid-19 test result taken at least 72 hours prior to your class.
YES
NO
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6
Please upload a photo of your COMPLETE Vaccination card / certificate
*
This field is required.
Please make sure that the photo shows your name, the dates of your vaccinations, and the type of vaccine you received. If you are not yet completely vaccinated, please upload a photo of your negative Covid-19 test result taken at least 72 hours prior to your class.
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7
Date & Time
*
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NOTE: One-on-one sessions until 4:00-5:00PM only
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8
Class Type
*
This field is required.
Please choose what class you are booking.
Aerial
Yin Yoga
Vinyasa Yoga
Hatha Yoga (non-heated)
Restorative Yoga
Vinyasa Yoga
Power Yoga
HOT Hatha Yoga
HOT Vinyasa Yoga
HOT YinYang Yoga
HOT Power Yoga
Inside Flow
Chair Yoga
Kids Yoga 6-10 y/o
Tweens Yoga 11-13 y/o
Family Yoga
Dance Fitness - Zumba
ONLINE PRIVATE CLASS
Pre Natal Yoga
Yoga Wheel
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9
NUMBER OF ATTENDEES
*
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Please indicate how many students will be attending the class.
1
2
3
4
5
6
7
8 (max for Aerial
9
10 (max for yoga)
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10
Please choose your payment option.
*
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All classes require full PRE-PAYMENT. Rates are found on the next page.
BDO Bank Transfer
GCash
Paypal
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11
PRIVATE CLASS RATES
For your reference
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12
PAYMENT DETAILS
Please read carefully ☺️ TAKE NOTE: Please email your proof of payment to the email address provided below with your NAME, CLASS DATE, and CLASS TYPE in the TITLE of your email. No proof of payment, no class confirmation.
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13
If you have a specific request for your class (particular teacher, class theme/peak pose, specific goals, etc) OR if you have any medical conditions that we need to know, please describe it in the box below.
We keep you information with utmost confidentiality and will only be used for the purposes of preparing for your class.
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