Gems of Yoga Teacher Training Program Application

Name *
Age *
Sex *
UAE Address *
Permanent Address *
Email *
Home Telephone
Mobile *
Passport No. *
D.O.I. *
D.O.E. *
Facebook Page *
Nationality *
Do you have insurance? *
Name and Contact No. of Insurance
Emergency Contact Information
Name *
Address *
Telephone *
Email *
Your relation to them? *
Have you discussed it with your family? *
If you have children, have you made arrangements for somebody to take care of your children while you attend training? *
If you have children, have you made arrangements for somebody to take care of your children while you attend training? *
How many hours of practice/study can you devote per day? *
How long and how have you physically practiced yoga? Please mention and explain any gaps in your practice e.g: if you practiced for one year then stopped then started again? *
Which studios, places, teachers or mentors have you practiced with? *
What type of Yoga have you practiced? *
Which Yoga tradition do you prefer if any? *
Which Yoga teacher/ classes/ experiences have been most important to you and why? *
Do you have a home practice? If so please describe. *
If you don’t have a committed Yoga practice of 2 years or more, please state the no. of hours that you will practice prior to start of the RYT 200 hours. *
Have you ever taught another personnel any Yoga posture or anything about Yoga, whether formally or informally? *
Please describe how your lifestyle reflexes Yoga dincharya or how you might like your lifestyle to do so in future? *
How you discussed becoming a Yoga Teacher with the member of our staff? *
Aside from YA certification to teach Yoga at the 200 hours level , what do you have to gain from the teacher training program at Gems of Yoga and what do you hope to share after being certified as a RYT 200? *
What would you like to see include or focused on during the course of teacher training at Gems Of Yoga? *
Please describe any volunteer work you do, describing the organization you support? *
Which communities (studio, corporate, pregnancy, children, trauma survivor, fifty plus,youth outreach, academic) are you interested in sharing Yoga with and why? *
Why do you practice yoga? *
Please submit a list of medical problems and any medication that you are taking? *
We are not looking perfection but rather for your expression of each posture?
Please submit a headshot for inclusion in the training workbook
Please note that you would not be allowed to proceed in the training if you are pregnant, so
please make sure before joining the training that you are not pregnant or there will be no
Waiver Clause
Release and Waiver of Liability
1. I warrant that I am over 18 years of age, in good health, and have no physical or mental
condition that would prevent me or render it inadvisable for me to participate in the yoga
intensive and teacher’s training program.
2. In consideration of receiving permission to participate in this program, I, for myself and
for my personal representatives, heirs and next of kin, hereby agree to release and
discharge from any liability whatsoever, and waive any and all claims I may have against
any person or entity involved with this program in any manner, including but not limited to
the Gems Of Yoga, Sunita Bhalla, Dr. Sanjay Sharma and each of their agents, employees,
students and representatives, as a result of any injury or damage, including death,
sustained by me or to my property while participating in this program, whether caused by
the negligence of any of the above named parties or others, and whether foreseen or
3. I understand that not all yoga exercises or practices are suitable for everyone and that
participation in the suggested exercises and practices may result in injury. With the
knowledge that any of these exercises and practices can result in injury, I hereby expressly
assume all risks associated with participation in this program, including the risk of injury or
damage resulting from performing any of these exercises and practices.
4. I further agree to indemnify and hold harmless any of the above named parties from any
claim by or against me arising out of my participation in this program, including all of their
attorney’s fees and costs.
5. I understand that the instruction and advice presented in this program is not intended as
a substitute for medical advice and counseling, and that one should consult a physician prior
to the start of any new exercises or practices. I consent to and permit emergency
treatment, medical or otherwise, in the event of injury or illness. I further release all
persons associated with this program in any manner from any claim whatsoever on account
of treatment or service rendered to me during this program.
Name (Signed) *
Registration No. Of Student
Payment Recieved
Pending Payment
Certificate No.
Programme Director Authorization:
Name (Signed)
RYT 200 Hours – Dhs 15,547/-
Dhs 550/- Application
First payment: Dhs 4999/-
Second payment: Dhs 4999/-
Third payment: Dhs 4999/-
Total Cost: DHS 15,547/-
The applicant must first submit the filled application form with non-refundable Dhs 1500/-
fees that would be adjusted in your tuition fees as an indication of your intention to join the
The payment can be made by cash or credit card at Gems Of Yoga Sheikh Zayed Road
I agree to the Terms and Conditions *
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