Online Yoga - Himalaya Yogashala

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ONLINE YOGA CLASS ENROLLMENT FORM

06:00 to 07:00 am Beginner to Intermediate
Monday to Friday
Online on Google Meet

Name

Email Id

Mobile

Date of Birth

Gender

MaleFemale

Marital Status

MarriedUnmarried

Are you experiencing any of the following health conditions? *

AsthmaEpilepsyHigh Blood PressureBack PainSchizophreniaOthers (Please specify)

If Yes, please specify

Have you undergone surgery in the past?*

YesNo

If Yes, please specify

Have you practiced Yoga before?

YesNo

If Yes, please specify for how long & when?

How did you come to know about Himalaya Yogashala?*

Friends & RelativesDigitallyOther...

I would like to enroll for*

1 month (INR 2000)3 Months (INR 5500)

Payment method*

CASHGPAY (+91 87774 79130)Bank Transfer

DECLARATION
I understand that any benefits derived from the course depend upon the extent of my participation. I therefore take full responsibility of the outcome. I willingly agree to follow all instructions and commit myself to attend all sessions without any exception. I also agree that I will not disclose the contents of this course to anyone. I declare that I am physically and mentally able to participate in this programme.

YesNo