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
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Time
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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.
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