Personal Information:

NAME:

GENDER:

DATE OF BIRTH:

ADDRESS:

PHONE NUMBER:

EMAIL ADDRESS:

EMERGENCY CONTACT

NAME:

RELATIONSHIP:

CONTACT PHONE NUMBER:

Questionnaire:

Complete all questions please

HOW LONG HAVE YOU BEEN PRACTICING YOGA ?

WHAT STYLES OF YOGA HAVE YOUR PRACTICED ?

HOW MANY TIMES PER WEEK DO YOU PRACTICE ?

DO YOU HAVE A HOME PRACTICE ?

IF YES, HOW MANY TIMES PER WEEK ?

DESCRIBE YOUR PRACTICE:

WHY ARE YOU TAKING THIS TEACHER TRAINING ?

LIST YOUR OTHER WORKSHOPS AND OR TRAINGINGS THAT MAY BE RELEVANT TO THIS COURSE:

WHAT ARE YOU LOOKING TO LEARN WITH THIS TRAINING?

ARE YOUR CURRENTLY TEACHING YOGA AND FOR HOW LONG?

WHAT STYLE(S) ?

PLEASE LIST ANY INJURIES AND OR HEALTH ISSUES WE SHOULD BE MADE AWARE OF?