The Yoga Mile - New Members Form
Email address *
Your age *
Your answer
Your full name *
Your answer
Your sex *
Your occupation *
Your answer
Your phone number *
Your answer
What time do you wake up and sleep? *
Your answer
What are your meal timings for breakfast, lunch, snacks and dinner? *
Your answer
What are your current working hours? *
Your answer
Please mention health concerns and surgeries undergone if any. *
Your answer
Please mention any weak organ or weak part of your body that you may be aware of. *
Your answer
Is there anything that worries you about the future? If yes, please indicate what it is. *
Your answer
What benefits do you seek from yoga? *
Your answer
Which of the below best describe your yoga practice requirements *
If not already joined, when are you planning to come for your first / trial session? (Please note, for personal yoga at home, trial class is to be paid for. For group classes, trial is free.) *
Your answer
How did you come to know about these classes? Please specify. *
Your answer
Pictures may be clicked occasionally for marketing and promotions. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of MICA. Report Abuse - Terms of Service - Additional Terms