Yoga Heals Us Chair Yoga for Every Body YTT Registration Form
all attendees for this training must complete this form upon registration
Email *
Date: *
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Name: *
Address: *
Primary Phone: *
Email: *
Date of Birth: *
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Pronoun *
Required
Gender *
Required
Occupation: *
Emergency Contact Name: *
Emergency Contact Phone Number: *
Personal Practice: How long have you practiced yoga? Describe your personal practice of yoga and how regularly you practice. *
Training Experience: What school(s) of yoga did you receive your YTT from and when? *
Teaching Experience: Are you currently teaching yoga? If so, how often do you teach yoga? *
Are you currently teaching Chair Yoga? If so, please describe your classes. *
Have you taken any Chair Yoga training programs? If so, which one(s)? *
Why do you want to take this course? *
What do you plan to do with Chair Yoga upon completion of this program? *
Do you have any special interests or capabilities that may be relevant to the group? *
Are you being treated for a medical condition? If yes, please describe. *
Have you had any injuries, major illnesses, or surgeries? If yes, please describe. *
How did you hear of our course? *
Are there any other things you would like to share?
Name as you would like it to appear on your certificate: *
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