Registration Form
Isha Hatha Yoga Programs offered by Hera Baboudjian
Email address *
Please fill in the information below in order to complete registration.This information will allow us to ensure that you can make the most of our Programs. All personal information will remain strictly confidential.
Program(s) you wish to Register for *
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Personal Information
First Name *
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Last Name *
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Date of Birth *
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Gender *
Occupation *
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Contact Information
Address *
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City *
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Country *
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Postal Code *
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Phone *
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Email *
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Emergency Contact Information
Please list details of someone to contact in case of emergency.
Name *
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Relationship *
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Phone number *
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Experience of Yoga
Please give details of the types of Yoga you have practiced, how long you have been practicing and how often do you practice. *
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Have you done Inner Engineering?
Health Information
Height *
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Weight *
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Please indicate if you currently suffer from, or have previously suffered from any of the following conditions: *
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If you have checked any of the above, please give details of the nature and duration of the condition. Please specify if you are currently on any medications. For what condition(s)? If yes, please describe any known side effects of these medications (e.g. change of heart rate, lack of coordination, etc.) that may impact your yoga practice:
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Women Only
Are you currently pregnant?
Allergy History
Please indicate if you currently experience any of the following allergies *
If you have checked any of the above, please give details of the nature of the allergy and the treatment required in case of emergency
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How did you hear about us?
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Comments
Please share any questions or comments you may have.
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Agreement
• I understand that what I am taught during the Yoga workshops/classes are only for my own practice, therefore I will not teach to others.
• I understand that Isha Hatha Yoga are tools for healthy living, but the workshops are not a substitute for medical attention, examination, diagnosis or treatment.
• I understand that Yoga practice includes physical movements as well as an opportunity for relaxation, stress re-education and relief of muscular tension.
• As is the case with any physical activity, the risk of injury is always present and cannot be entirely eliminated. If I experience any pain or discomfort, I will seek guidance from the teacher.
• Yoga is not recommended and is not safe under certain medical conditions, therefore I will provide accurate information about my health condition and follow given advice.
• I hereby willingly undertake to attend this program completely. I take full responsibility for the result and indemnify the teacher, Hera Baboudjian, against all claims and suits. I will not communicate the contents of the program, either directly or indirectly to anyone else. I understand the participation guidelines and agree to follow them.

I hereby agree with the above statements and I declare that the above information is true, accurate and complete to the best of my knowledge. *
During our programs, we sometimes take photos for our portfolio / promotion /web content. If you do not wish to be photographed, or give permission for these intent, please let us know. *
Date *
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Thank you! It will be a pleasure to have you join our Program!
Once we receive your completed Registration Form, we will email you to confirm this, along with details on payment modalities. Please make sure you have shared your correct email address and please contact us at hathayogawithhera@gmail.com in case you have not received any confirmation email in the following few days.
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