PADMAKARMA YOGA TTC (RYS 200)
REGISTRATION CARD
I agree to assume full responsibility for myself and for all my personal property, and I agree that the extent of my participation in all activities shall be left to my own good judgement and shall be entirely at my own risk and peril. I further agree not to hold Padmakarma Yoga Institute or any other person responsible for in any injury/damage. I also understand that no cash refunds will be given under any circumstances.
I sincerely endeavour to make genuine efforts towards my own well being and self improvement.
NAME
Your answer
COURSE MONTH - 2018
COURSE MONTH - 2019
SEX
NATIONALITY
Your answer
ADDRESS1
Your answer
Address 2
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Email
Your answer
Phone
Your answer
Date of Birth
MM
/
DD
/
YYYY
Profession
Your answer
Any illness/special medical condition:
Your answer
Allergy / Food Allergy
Your answer
Emergency Contact
Your answer
Mobile
Your answer
Email
Your answer
Brief Yoga Background
Your answer
Any self Practice/Meditation/Pranayama?
Your answer
Are you open to receive different style of yoga?
Your answer
Why do you want to be a teacher?
Your answer
What is your expectation?
Your answer
Any further info
Your answer
Passport number
Your answer
Date of issue
MM
/
DD
/
YYYY
How did you hear about us?
Submit
Never submit passwords through Google Forms.
This form was created inside of PadmaKarma.