Om Factory Private Session Request
Please fill out this form with as much information as possible so that we can best answer any questions you have, and assist you in booking a private session.

Please allow 2-3 business days to process your request. If your request is within 48 hours, call our studios directly to speak with a staff member.

Please Note: This form is NOT confirmation of booking.
First Name *
Last Name *
E-mail Address *
Phone Number *
Preferred Date and Time *
If this date and time is not available, we will offer you an alternative close to your preference
Preferred Teacher
This teacher may not be available to teach your private, and teacher is subject to change.
Type of Private *
IF you chose MAT, which apparatus would you like? (Select N/A if you selected AERIAL or CIRCUS) *
IF you chose AERIAL, which apparatus would you like? (Select N/A if you selected MAT or CIRCUS) *
IF you chose CIRCUS, which apparatus would you like? (Select N/A if you selected AERIAL or MAT) *
Length of Private *
CIRCUS and Kids AERIAL are 60 minutes ONLY.
I would like my private to be... *
ie. Vigorous, Gentle/Mellow, Acrobatic, Restorative, Flowing, Flow & Mellow, etc.
My goals for this private are... *
ie. To have fun, to build up to a group class, to become stronger, to become more flexible, etc.
Level of Private *
Number of participants *
Are minors participating? (under age 18) *
If minors are participating, are any minors under age 13? *
If minors are participating, what is the age range of the participants? *
Write "N/A" if not applicable
Yoga/Movement background of the participants *
Special Requests
ie. Party, Theme, Music, Injuries, Pregnancy, Special Needs, etc.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy