Wheel Yoga Teacher Training Application Form
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Course You Would Like to Attend : *
How did you hear about our Wheel Yoga Teacher Training? *
Your Details
First Name *
Last Name *
Gender *
Date of Birth *
E-mail Address *
Confirm E-mail Address *
Mobile Phone (incl. country code) *
Home Street Address *
Home Street Address 2 *
City *
Postal Code *
Country *
Emergency Contact Name *
Emergency Contact Phone *
Facebook URL/Name
Instagram URL/Handle
What is your current Yoga Certification? *
Please list your yoga teaching experience  (if any):
Why did you decide to do Wheel Yoga Teacher Training? What are you goals with this course? *
Do you have any health or medical conditions that may affect your ability to participate fully and safely in this program? *
Has any medical doctor or health professional advised against yoga, fitness, or other forms of exercises? *
Are you taking any medications? *
Do you use recreational drugs or alcohol? Please be honest. *
Do you have any food allergies? *
Do you have any dietary restrictions? Please list. *
Anything else you would like us to know about you?
Trainee Course Terms Agreement
I understand that this course is not a retreat, it's a training, and it will be mentally and physically challenging. *
I take full responsibility for my own health and well-being during the course and will not hold Rosita Jan or any of the teaching staff responsible for injuries or other medical problems that might occur. *
I understand that registering and joining the course does not guarantee certification—certification is merit based only. *
I understand that a positive, team-oriented, optimistic attitude is a requirement for all trainees. Disruptive, rude, or negative behaviour will not be tolerated and may result in removal from the course. *
I understand that the deposit payment for the course is not refundable *
One last thing...
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