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International Yog Day - 108 Surya Namaskār
This is a screening tool to ensure safety of participants and know about their fitness and motivation level.
* Indicates required question
Would you be able to commit to participating in 108 Surya Namaskar on International Yoga Day: 21st June 2020 and commit to disciplined practice at home as well as weekly online group sessions?
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Yes
No
Full Name
*
Your answer
Date of Birth
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MM
/
DD
/
YYYY
Do you practice Surya Namaskar?
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Yes
No
Other:
Contact Information (Phone Number with Country Code)
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Your answer
Which country will you be participating from?
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Your answer
Do you have any health-related conditions that may hinder your participation in the event? Do you have any health-related conditions that may be aggravated by participating in the event? (If Yes: Please list down all; If no: Please mention None)
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Your answer
Before beginning the practise sessions identify any medical conditions that you may have which could be unsafe for participation or require a doctors referral
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Uncontrolled High Blood Pressure
Stroke
Joint Replacement
Heart Disease
Osteoporosis
Recent Fractures
Pregnancy
Uncontrolled Diabetes
None
Other:
Required
Are you currently taking any medications? (If yes: list all; If no: mention none )
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Your answer
Would you be able to practice Surya Namaskar every day at home?
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Yes
No
Would you be able to connect via video conference or Facebook/ Instagram live for the practice sessions?
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Yes
No
Would you be able to participate in weekly online sessions (every Sunday morning ~1 hour) with the instructors?
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Yes
No
Describe your fitness level
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Do not Exercise or perform Yoga
Mild: Once a week, 30 to 60 minute of yoga, running, swimming or any other activity
Moderate: Thrice a week, 30 to 60 minute of any type of physical activity
Vigorous: Five or more days a week, 30 to 60 minutes of intense physical activity
If you answered Mild, Moderate or Vigorous for above: Describe the type and duration of physical activity. Since when have you been performing the physical activity?
Your answer
What motivated you to participate in this event?
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Your answer
Would you be willing to share your Facebook and/or Instagram profile for digital marketing?
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Yes
No
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