The Heart of Sound Application Form - Torquay
Thank you for filling out the required questions, marked with a red*
Please note only registrations accompanied by payment via kate@yokeyoga.com.au will receive responses. Please email with any questions.
We look forward to joining with you soon in the Heart of Sound! :)
Your First & Last Name Please *
Your answer
Phone Number: *
Your answer
Email Address: *
Your answer
I am applying for: *
(Note: Module 2 applications will be processed by email and admittance is granted upon completion of the required homework and/or prerequisites.)
What is your occupation? *
Your answer
How do you plan to use this training in your personal or professional life?
Your answer
Is there any part of the program you're particularly excited about?
Your answer
Have you attended a yoga teacher training or transformational retreat before?
Please detail any previous training that might be related to this course: yoga, degree in psychology, philosophy, meditation, music, spiritual teachings, etc.
Your answer
What experience do you have with Sanskrit and/or mantra ? (None is required.) *
Your answer
What is your musical background? (None is required.) *
Your answer
Have you ever been treated, hospitalized, or medicated for psychiatric problems? *
Your answer
Are you on any medications? Please list type of medicine and duration of treatment: *
Your answer
Do you have any physical issues, illnesses, or injuries that the yogāsana and vocal yoga instructors should be aware of? *
Have you been advised by your doctor of any physical restrictions?
Your answer
Will you turn in the prerequisite reports 30 days before our training?
Do you have any other special needs or requests? *
Your answer
Emergency Contact Person 1 *
Name, relation to you, location, phone number, and email address
Your answer
Emergency Contact Person 2 *
Name, relation to you, location, phone number, and email address
Your answer
Acknowledgement of Responsibility and Waiver of Liability *
All participants in yoga, mantra, physical training activities and counseling/mentoring with Anandra George (and others who may be designated as teachers/facilitators) acknowledge that they have determined on their own that they are capable of undertaking the activities presented and will use their own judgment in deciding to participate or not participate accordingly. The undersigned agrees to the above and waives any claim of liability on the part of the above mentioned hosts/teachers/presenters/facilitators in relation to the undersigned’s participation in the activities presented, and in any outside activities undertaken by the participant, and any incidents that may occur at the teaching venue or at any other location while participating in this retreat, training, class or workshop.
Required
Your Electronic Signature & Date of Signing *
Your signature formally acknowledges responsibility and liability waiver above.
Your answer
Are you looking forward to immersion in the Heart of Sound? ;)
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