Hatha Yoga, Yoga Nidra & Restorative registration

Which class are you interested in

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Town

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Occupation

Age

Are you currently doing any sport or type of exercise?
YesNo

If yes which

Why have you come to Yoga and what do you hope to gain from it?

Have you done Yoga before?
YesNo

If yes, how long have you been practising for?

What style?

Have you ever practiced Pilates/Tai Chi/etc?
YesNo

If yes, which?

Are you currently taking any form of medication?
YesNo

If yes, please give details

Please give details of any medical conditions which might affect your Yoga practice

Have you suffered any injury or undergone any surgery (i.e. cesarean section, knee surgery, etc) which might affect your Yoga practice? If so, please give details

Do you have any allergies or dietary requirements:
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If yes, what kind

How did you hear about the class?

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