YTTC Application Form
Please complete all sections of this application in as much detail as possible so we can fully assess your suitability for the Yoga Teacher Training with Emily Young. Any information shared here is strictly confidential.
Email address *
Name *
First and last name
Your answer
Address *
Your answer
Phone number *
Your answer
What is your occupation?
Your answer
How long have you been practicing yoga? *
Required
Do you have any experience of the following? *
Required
Where do you currently practice your yoga? *
Your answer
How many times a week to you practice yoga? *
Your answer
Do you have a regular teacher you like to practice with? *
Your answer
Please explain why this teacher inspires you to keep showing up on the mat? (Minimum 100 words, maximum 500 words) *
Your answer
Please explain why you practice yoga - what are the benefits for you and what are the your challenges? (Minimum 100 words, maximum 500 words) *
Your answer
Do you hold any other related qualifications? (physical activities, fitness, health, massage, education etc)? *
Your answer
Health Questionaire *
Yes
No
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
Do you feel pain in your chest when you perform physical activity?
In the past month, have you had chest pain when you were not performing anyphysical activity?
Do you lose your balance because of dizziness or do you ever loseconsciousness?
Do you have a bone or joint problem that could be made worse by a change inyour physical activity?
Is your doctor currently prescribing any medication for your blood pressure orfor a heart condition
Do you know of any other reason why you should not engage in physicalactivity?
Do you have any other injuries or medical conditions we should be aware of?
If you have answered “Yes” to one or more of the above questions, consult your doctor before engaging in this physically active course. Tell your doctor which questions you answered “Yes” to. After a medical evaluation, seek advice from your doctor if this course is suitable for your current condition and consult with Emily. Please give details of any injuries or medical conditions we should know about below:
Your answer
Emergency contact details : Name and contact number. *
Your answer
Which payment option would you like ? *
I have read and Agreed with the YTTC Terms and Conditions ( available at https://emilyyoungyoga.com/emilys-diary/) *
A copy of your responses will be emailed to the address you provided.
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