NKV Holistic Living- Participant Registration Form
Email *
Which programme are you attending? *
Full Name *
What is your age group? *
Address
City *
Postcode/ Pin code *
County/ State/ Province *
Country *
Phone number *
Gender *
Profession *
Do you have any health condition? If so, please mention below.
[We use this information to take precautions while instructing during the practice sessions. Please inform us in advance if you feel the need to do so. The information entered is subject to confidentiality.]
Have you undergone any surgery in the past 6 months? (Eg: heart or knee surgery) *
Please note: If you have undergone a major surgery, we advise you to consult your GP or a licensed doctor for advice before attending the programme.
Required
If selected 'Yes' for the previous question, please mention details. This may include details such as the type of surgery, date, doctors advice etc.
This helps us take precautions and instruct accordingly in the practice sessions of the programme.
Which of the following courses have you attended in the past?
What are you expectations from the NKV Holistic Living programmes? This helps us better the quality of our service to you!
Participant Consent *
Required
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