Reserve Your Space
This is a preliminary registration form for all of our courses. All details provided are kept strictly confidential.
If this is your first time filling out the form please be sure to enter all requested information. If you have already completed this form only enter the required* information and any information that may have changed since you last completed it.
Name & Surname *
Your answer
Is this your first time completing this form? *
Course codes/names (please specify which classes, courses, workshops, or other services you are interested in. If you have a course code enter it here): *
Your answer
City/Country of Residence
Your answer
Mobile Number
Your answer
Email
Your answer
What interests you the most about Yoga?
Have you practiced Yoga before?
For how long?
Age:
Your answer
Please mark your current health concerns, if any:
In the last 5 years have you had any serious illnesses/ hospitalisations/ injuries? Please explain.
Your answer
Do you have any allergies or food sensitivities? Please explain:Your answer
Your answer
If you are receiving treatment with any physicians, healers, or therapists, please list them:
Your answer
If applicable, please describe your menstrual / hormonal health (i.e. irregular, cramps, PMS, menopause, etc.)
Your answer
If you are inquiring about the Yoga Teacher Training, briefly answer the following: (1) what does “yoga” mean to you? (2) what are your intentions & inspirations for completing this course? (3) what draws you to our course in particular? (there are no “right” or “wrong” answers, this is just to gain insight on how we can best assist you)
Your answer
Additional comments, questions or concerns:
Your answer
How did you find out about us?
Would you like to be updated on future classes, courses, and workshops?
PLEASE NOTE
We try to make space for everyone, so feel free to join us, whenever!

FINDING US: the space we primarily teach in (Durban Yoga Shala) has no signage: it's on 230 Musgrave St, but the ENTRANCE IS ON ST. THOMAS ST. Plan to arrive early so you can settle in calmly.

If you have specific questions about an upcoming event email us directly at info@innerwellnessstudio.com or contact Diego at 0792623877 (call or WhatsApp message is best).

If you would like to make a deposit or payment for one of the courses or workshops you can pay cash in person or via EFT to the following account: D Baldi; FNB Cheque Acc. No. 62191378390 Branch 220128
Thank you for taking the time to complete the form. Be sure to press “submit” when you finish.
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